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  1. Clinical evaluation of amylase-creatinine clearance ratio and amylase isoenzyme clearance in chronic renal failure.

    Science.gov (United States)

    Maeda, M; Otsuki, M; Okano, K; Yamasaki, T; Baba, S

    1981-01-01

    Amylase-creatinine clearance ratio (ACCR) and amylase isoenzyme clearance were determined simultaneously in patients with chronic renal failure. ACCR in patients with compensated renal failure (3.5 +/- 0.4%) was not significantly different from normals (2.6 +/- 0.2%), while that in patients with non-compensated renal failure (6.7 +/- 0.4%) was significantly higher than that in normals. Clearance ratio of pancreatic isoamylase (Amylase-1) relative to creatinine clearance (CAmy . 1/Ccr) in patients with both compensated (5.9 +/- 1.0%) and non-compensated (6.8 +/- 0.4%) renal failure was as high as that in patients with acute pancreatitis (6.6 +/- 0.5%). On the other hand, clearance ratio of salivary isoamylase (Amylase-3) relative to creatinine clearance (CAmy . 3/CCr) in patients with compensated renal failure (1.5 +/- 0.3%) was almost the same as that in normals (2.1 +/- 0.1%), while that in patients with non-compensated renal failure was 5.9 +/- 0.7%, which was significantly higher than that in normals. The present study revealed that elevated ACCR in patients with severely impaired renal function was due to the increase of the clearance ratio for both pancreatic and salivary amylase. These facts suggested that glomerular permeability and tubular reabsorption for pancreatic and salivary amylase might play an important role on ACCR in patients with severely impaired renal function.

  2. Clinical evaluation of amylase-creatinine clearance ratio and amylase isoenzyme clearance in chronic renal failure.

    Science.gov (United States)

    Maeda, M; Otsuki, M; Okano, K; Yamasaki, T; Baba, S

    1981-01-01

    Amylase-creatinine clearance ratio (ACCR) and amylase isoenzyme clearance were determined simultaneously in patients with chronic renal failure. ACCR in patients with compensated renal failure (3.5 +/- 0.4%) was not significantly different from normals (2.6 +/- 0.2%), while that in patients with non-compensated renal failure (6.7 +/- 0.4%) was significantly higher than that in normals. Clearance ratio of pancreatic isoamylase (Amylase-1) relative to creatinine clearance (CAmy . 1/Ccr) in patients with both compensated (5.9 +/- 1.0%) and non-compensated (6.8 +/- 0.4%) renal failure was as high as that in patients with acute pancreatitis (6.6 +/- 0.5%). On the other hand, clearance ratio of salivary isoamylase (Amylase-3) relative to creatinine clearance (CAmy . 3/CCr) in patients with compensated renal failure (1.5 +/- 0.3%) was almost the same as that in normals (2.1 +/- 0.1%), while that in patients with non-compensated renal failure was 5.9 +/- 0.7%, which was significantly higher than that in normals. The present study revealed that elevated ACCR in patients with severely impaired renal function was due to the increase of the clearance ratio for both pancreatic and salivary amylase. These facts suggested that glomerular permeability and tubular reabsorption for pancreatic and salivary amylase might play an important role on ACCR in patients with severely impaired renal function. PMID:6167484

  3. Highly fluorescent resorcinarene cavitand nanocapsules with efficient renal clearance

    Science.gov (United States)

    Mahadevan, Kalpana; Patthipati, Venkata Suresh; Han, Sangbum; Swanson, R. James; Whelan, Eoin C.; Osgood, Christopher; Balasubramanian, Ramjee

    2016-08-01

    Nanomaterial based imaging approaches hold substantial promise in addressing current diagnostic and therapeutic challenges. One of the key requirements for the successful clinical translation of nanomaterials is their complete clearance from the body within a reasonable time period preferably via the renal filtration route. This article describes the synthesis of highly fluorescent, water soluble, resorcinarene cavitand nanocapsules and demonstrates their effective renal clearance in mice. The synthesis and functionalization of nanocapsules was accomplished in a one-pot operation via thiol-ene reactions without involving self-assembly, sacrificial templates or emulsions. Water soluble resorcinarene cavitand nanocapsules obtained by this approach were covalently functionalized with Alexa Fluor 750. Highly fluorescent nanocapsules with hydrodynamic diameters of 122 nm and 68 nm and extinction coefficients of 1.3 × 109 M-1 cm-1 and 1.5 × 108 M-1 cm-1 respectively were prepared by varying the reaction conditions. The in vivo biodistribution and clearance of these nanocapsules in mice followed by whole-body fluorescence imaging showed that they were both cleared renally within a few hours. Given the inherent encapsulation capabilities of nanocapsules, the renal clearance demonstrated in this work opens up new opportunities for their theranostic applications especially for targeting and treating the urinary tract.

  4. In Vivo Renal Clearance, Biodistribution, Toxicity of Gold nanoclusters

    CERN Document Server

    Zhang, Xiao-Dong; Shen, Xiu; Liu, Pei-Xun; Fan, Fei-Yue; Fan, Sai-Jun; 10.1016/j.biomaterials.2012.03.020

    2012-01-01

    Gold nanoparticles have shown great prospective in cancer diagnosis and therapy, but they can not be metabolized and prefer to accumulate in liver and spleen due to their large size. The gold nanoclusters with small size can penetrate kidney tissue and have promise to decrease in vivo toxicity by renal clearance. In this work, we explore the in vivo renal clearance, biodistribution, and toxicity responses of the BSA- and GSH-protected gold nanoclusters for 24 hours and 28 days. The BSA-protected gold nanoclusters have low-efficient renal clearance and only 1% of gold can be cleared, but the GSH-protected gold nanoclusters have high-efficient renal clearance and 36 % of gold can be cleared after 24 hours. The biodistribution further reveals that 94% of gold can be metabolized for the GSH-protected nanoclusters, but only less than 5% of gold can be metabolized for the BSA-protected nanoclusters after 28 days. Both of the GSH- and BSA-protected gold nanoclusters cause acute infection, inflammation, and kidney fu...

  5. CLEARANCE OF INDOMETHACIN OCCURS PREDOMINANTLY BY RENAL GLUCURONIDATION

    NARCIS (Netherlands)

    MOOLENAAR, F; CRANCRINUS, S; VISSER, J; DEZEEUW, D; MEIJER, DKF

    1992-01-01

    In this report we describe the conditions of collection, storage and handling of urine samples, collected after oral dosing with indometacin in man, in order to maintain the integrity of the labile glucuronide formed. We found that the body clearance occurs predominantly by renal metabolism, due to

  6. Renal clearance of pancreatic and salivary amylase relative to creatinine in patients with chronic renal insufficiency.

    Science.gov (United States)

    Keogh, J B; McGeeney, K F; Drury, M I; Counihan, T B; O'Donnell, M D

    1978-12-01

    Pancreatic and salivary amylase/creatinine clearance ratios in patients with various degrees of renal impairment were compared with those obtained for control subjects. In chronic renal insufficiency (mean GFR 30 ml/min +/- 15 SD; n = 13) the clearance ratios for pancreatic (mean 3.5 +/- 1.85 SD) and salivary (mean 2.3 +/- 1.3 SD) amylase were significantly higher (P less than 0.05) than those in controls. Corresponding control values (n = 26) were 2.64 +/- 0.86 (pancreatic) and 1.64 +/- 0.95 (salivary). Three patients showed values above the normal limit. In the diabetic group (mean GFR 41 ml/min +/- 22 SD; n = 10) salivary amylase/creatinine clearance ratios (mean 2.36 +/- 1.55 SD) were significantly higher than in controls (P less than 0.05). Three patients showed raised values. Pancreatic amylase clearance was raised in only one of these patients. Three patients with terminal disease (mean GFR 10 ml/min) showed markedly raised (two- to threefold) clearance ratios for both salivary and pancreatic amylase. Of a total of 26 patients, eight had increased total amylase/creatinine clearance ratios. Pancreatic amylase/creatinine clearance was increased in seven patients, while nine patients showed raised salivary amylase/creatinine ratios. Patients with raised clearance ratios did not have clinical evidence of pancreatitis. We suggest that, in the presence of impaired renal function, a high amylase/creatinine clearance ratio need not be indicative of pancreatic disease.

  7. 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.

    Science.gov (United States)

    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

  8. RENAL CLEARANCE AND URINARY EXCRETION OF CIPROFLOXACIN IN GOATS

    Directory of Open Access Journals (Sweden)

    Z. IQBAL, I. JAVED, B. ASLAM, F. MUHAMMAD AND I. U. JAN

    2007-10-01

    Full Text Available The renal clearance and urinary excretion of ciprofloxacin were investigated in eight healthy female goats. In each animal, ciprofloxacin was administered intramuscularly at the rate of 5 mg/kg body weight. Following drug administration, blood and urine samples were collected at different time intervals and analyzed for ciprofloxacin and creatinine. High performance liquid chromatography (HPLC was used to determine the drug concentration in the plasma and urine. The value of diuresis after single administration of ciprofloxacin was 0.073 ± 0.014 ml/min/kg. Mean (± SE values for renal clearance of creatinine and ciprofloxacin were 1.870 ± 0.385 and 0.982 ± 0.166 ml/min/kg, respectively. The ratio between the renal clearance of ciprofloxacin and that of creatinine remained less than one, which was indicative of back diffusion. The mean (± SE value for the cumulative percent of ciprofloxacin dose excreted at 10 hours following its intramuscular administration was 13.03 ± 2.07. Based on these results, it was evident that besides glomerular filtration, renal handling of drug involved back diffusion also. It was concluded that in local goats glomerular filtration rate (GFR was lower than that reported for their foreign counterparts.

  9. Highly Catalytic Nanodots with Renal Clearance for Radiation Protection

    OpenAIRE

    Zhang, Xiao-Dong; Zhang, Jinxuan; Wang, Junying; Yang, Jiang; Chen, Jie; Shen, Xiu; Deng, Jiao; Deng, Dehui; Long, Wei; Sun, Yuan-Ming; Liu, Changlong; Li, Meixian

    2016-01-01

    Ionizing radiation (gamma and x-ray) is widely used in industry and medicine, but it can also pose a significant hazardous effect on health and induce cancer, physical deformity and even death, due to DNA damages and invasion of free radicals. There is therefore an urgent unmet demand in designing highly efficient radioprotectants with synergetic integration of effective renal clearance and low toxicity. In this study, we designed ultrasmall (sub-5 nm) highly catalytically active and cysteine...

  10. Decreased renal clearance of digoxin in chronic congestive heart failure.

    Science.gov (United States)

    Naafs, M A; van der Hoek, C; van Duin, S; Koorevaar, G; Schopman, W; Silberbusch, J

    1985-01-01

    Renal digoxin clearance was compared in patients suffering from atrial fibrillation with well preserved cardiac function (n = 9; salt intake +/- 170 mmol daily) and patients with chronic congestive heart failure (n = 10; salt intake 50 mmol daily and maintenance treatment with diuretics). There was no difference between the groups concerning digoxin dosage, creatinine clearance, diuresis or sodium excretion in the urine. Digoxin clearance in chronic heart failure proved to be significantly lower than in atrial fibrillation (48 +/- 21 vs 71 +/- 36 ml X min-1, p less than 0.05), and Cdig/Ccreat was similarly reduced at 0.73 +/- 0.15 compared to 1.09 +/- 0.27 (p less than 0.005). Steady state serum digoxin concentration was significantly higher in patients with congestive heart failure (1.44 +/- 0.47 vs 0.87 +/- 0.33 micrograms X 1(-1), p less than 0.01). Chronic congestive heart failure is a state with reduced digoxin clearance by the kidney, which could lead to digoxin intoxication not explicable by overdose, reduced renal function or the effect of interacting drugs. PMID:4007028

  11. Spontaneous Clearance of Hepatitis C after Liver and Renal Transplantation

    Directory of Open Access Journals (Sweden)

    CH Dale

    2009-01-01

    Full Text Available Spontaneous clearance of hepatitis C virus (HCV is rare in immunocompromised patients, such as those who have undergone organ transplantation. It has been recognized that patients receiving liver transplantation for HCV-related disease have decreased graft and patient survival compared with those transplanted for other etiologies. There is a growing trend toward treating HCV recurrence aggressively after liver transplantation. For other organ transplant recipients with concurrent HCV, treatment is not often an option, given the high rates of graft rejection and loss secondary to interferon and its immunomodulatory effects. Although spontaneous clearance of HCV has been reported in recipients of solitary liver and renal transplants, a common factor arising in these cases has been previous exposure to interferon. To date, no reports of spontaneous clearance of HCV RNA have been reported in a multiorgan transplant recipient. A case of spontaneous clearance of HCV RNA in an immunocompromised patient, within five months of simultaneous liver and kidney retransplantation is described. Importantly, this patient had no previous exposure to interferon.

  12. Renal Clearance: Using an Interactive Activity to Visualize a Tricky Concept

    Science.gov (United States)

    Hull, Kerry

    2016-01-01

    Renal clearance, the volume of blood cleared of a substance in a particular time period, is commonly recognized as one of the most difficult concepts in physiology. This difficulty may in part reflect the quantitative nature of renal clearance since many life sciences majors perceive that mathematics is irrelevant to their discipline. Students may…

  13. Highly Catalytic Nanodots with Renal Clearance for Radiation Protection

    CERN Document Server

    Zhang, Xiao-Dong; Wang, Junying; Yang, Jiang; Chen, Jie; Shen, Xiu; Deng, Jiao; Deng, Dehui; Long, Wei; Sun, Yuan-Ming; Liu, Changlong; Li, Meixian

    2016-01-01

    Ionizing radiation (gamma and x-ray) is widely used in industry and medicine, but it can also pose a significant hazardous effect on health and induce cancer, physical deformity and even death, due to DNA damages and invasion of free radicals. There is therefore an urgent unmet demand in designing highly efficient radioprotectants with synergetic integration of effective renal clearance and low toxicity. In this study, we designed ultrasmall (sub-5 nm) highly catalytically active and cysteine-protected MoS2 dots as radioprotectants and investigated their application in protection against ionizing radiation. In vivo preclinical studies showed that the surviving fraction of MoS2-treated mice can appreciably increase to up to 79 % when they were exposed to high-energy ionizing radiation. Furthermore, MoS2 dots can contribute in cleaning up the accumulated free radicals within the body, repairing DNA damages and recovering all vital chemical and biochemical indicators, suggesting their unique role as free radical...

  14. Serum amylase activity and renal amylase activity clearance in patients with severely impaired renal function and in patients treated with renal allotransplantation.

    Science.gov (United States)

    Pedersen, E B; Brock, A; Kornerup, H J

    1976-03-01

    Serum amylase activity was measured in 29 nondialysed patients with severe renal failure, in 24 uraemic patients treated with chronic haemodialysis, and in 29 patients treated with renal allotransplantation. Simultaneous measurement of renal amylase activity clearance (CAm) and creatinine clearance (CCr) was performed in 25 patients with severe renal failure and in 19 transplanted patients. Serum amylase activity was elevated in all three groups. CAm was significantly correlated to CCr both in the group with severe renal failure and in the transplanted group. Unlike in the group of transplanted patients, the ratio CAm/CCr was significantly increased in patients with severe impaired renal function. It is concluded that the elevation of serum amylase activity in patients with impaired renal function is primarily due to decreased glomerular filtration rate. The value of CAm/CCr for diagnosing acute pancreatitis is doubtful in patients with severe renal disease.

  15. Assessment of compensatory renal function and [125I]iothalamate clearance in sheep.

    Science.gov (United States)

    Filippich, L J; English, P B; Ainscow, J

    1985-11-01

    Compensatory renal function and sodium [125I]iothalamate clearance were studied in 4 adult Merino ewes. Renal clearances of inulin (CIN), iothalamate (CIOT), and p-aminohippurate (CPAH) were used to measure renal function before and 7 and 170 days after 50% and 75% reductions in renal mass. Renal mass reduction to 50% of normal was achieved by ligation of the right renal artery, and to 25% of normal by ligating the right renal artery and branches of the left renal artery. Renal function (CIN and CPAH) after 50% renal mass reduction was 78% of normal on postligation day (PLD) 7 and 64% of normal on PLD 170. This decrease in renal function between PLD 7 and 170 was significant (P less than 0.05). Renal function (CIN and CPAH) after 75% renal mass reduction was 55% of normal on PLD 7 and 48% on PLD 170; however, this decrease in renal function between PLD 7 and 170 was not significant. Results indicated that, shortly after 50% renal mass reduction by renal arterial ligation, renal function in ewes was greater than that previously reported after unilateral nephrectomy and that a further decrease in renal function developed within 6 months after ligation. The mean CIOT in healthy ewes was 2.46 ml/min/kg of body weight. In healthy ewes and in ewes after renal mass reduction, regression of the simultaneous CIOT and CIN was CIOT = 0.276 + 1.05 CIN. The CIOT was higher than the corresponding CIN, and remained significantly (P less than 0.01) and consistently higher. Therefore, iothalamate can be used to estimate glomerular filtration rate in sheep, although a correction factor is required.

  16. Amylase-creatinine clearance ratios and serum amylase isoenzymes in moderate renal insufficiency.

    Science.gov (United States)

    Banks, P A; Sidi, S; Gelman, M L; Lee, K H; Warshaw, A L

    1979-12-01

    Both the amylase-creatinine clearance ratio (normal 1.55%) and proportion of pancreatic isoamylase in serum (normal 41.0%) increase in acute pancreatitis, and are therefore useful measurements to support that diagnosis. Whether renal insufficiency interferes with the accuracy and specificity of these tests has been debated. Our study indicates that even moderate renal insufficiency (creatinine clearance 30.5 ml/minute) raises the amylase-creatinine clearance ratio (3.23%) close enough to values characteristic of acute pancreatitis (4.41%) to cause potential diagnostic confusion. The fraction of pancreatic isoamylase in serum is also increased (69.9%), but not to the levels of acute pancreatitis (91.0%). We therefore caution against the use of the amylase-creatinine clearance ratio for the diagnosis of acute pancreatitis in patients with moderate renal insufficiency.

  17. Serum amylase determinations and amylase to creatinine clearance ratios in patients with chronic renal insufficiency.

    Science.gov (United States)

    Tedesco, F J; Harter, H R; Alpers, D H

    1976-10-01

    Patients with severe chronic renal failure may have significant hyperamylasemia in the absence of clinical symptoms or signs of acute pancreatitis. Amylase to creatinine clearance (CA/CC) ratios were usually elevated in patients with chronic renal failure and were not helpful in evaluating the possibility of acute pancreatitis. The mean amylase to creatinine clearance ratio for the controls with normal renal function was 1.24 +/- 0.13. In patients with chronic renal failure, it was 3.17 +/- 0.42 (P less than 0.001). Serum amylase isoenzyme patterns revealed no difference in salivary to pancreatic isoenzyme ratios between normals (1.04 +/- 0.12) and patients with severe renal insufficiency without evidence of pancreatic disease (1.07 +/- 0.13). The isoenzymes were helpful in excluding the diagnosis of pancreatic in 1 renal failure patient whose hyperamylasemia was primarily salivary in origin and in confirming the diagnosis in another who had only a pancreatic band.

  18. Effect of glucagon infusion on the renal clearance of amylase relative to creatinine.

    Science.gov (United States)

    Tedesco, F J; Davila, E; Gardner, L B

    1978-10-01

    Recent data seem to support a tubular defect as the mechanism of the elevated renal clearance of amylase relative to creatinine in acute pancreatitis. Glucagon has been proposed by some to be an important factor in this phenomenon. To examine the role of glucagon as this "tubular dysfunction factor", we investigated the effect of intravenously infused glucagon on the fractional excretion of amylase and the tubular handling of a low molecular weight protein, beta2 microglobulin, in normal, healthy volunteers. At glucagon levels far in excess of those seen in pancreatitis, the clearance ratio of beta2 microglobulin relative to creatinine increased, whereas the clearance ratio of amylase relative to creatinine did not increase above the normal range. The dissociation between beta2 microglobulin clearance and amylase clearance allows one to question the theory that tubular dysfunction is the mechanism of the elevated renal clearance of amylase relative to creatinine in acute pancreatitis. Glucagon does not appear to be the sole factor responsible for the elevation of renal clearance of amylase relative to creatinine in acute pancreatitis.

  19. 51Cr-EDTA plasma clearance in severe renal failure determined by one plasma sample

    DEFF Research Database (Denmark)

    Kamper, A L; Nielsen, S L

    1989-01-01

    Two hundred and thirty-four measurements of standard 51Cr-EDTA plasma clearance were made in 50 patients with severe chronic renal failure. Based on these data two calculation methods were attempted using one plasma sample drawn 24 h after injection of 51Cr-EDTA. One of the methods used the 'one...... renal dysfunction (estimated clearance values below 21 ml/min) may be determined with adequate precision by one plasma sample drawn at 24 h after injection of the tracer without sampling at 5 h. This appears to be a very practical simplification....

  20. Megalin and cubilin are endocytic receptors involved in renal clearance of hemoglobin

    DEFF Research Database (Denmark)

    Gburek, Jakub; Verroust, Pierre J; Willnow, Thomas E;

    2002-01-01

    The kidney is the main site of hemoglobin clearance and degradation in conditions of severe hemolysis. Herein it is reported that megalin and cubilin, two epithelial endocytic receptors, mediate the uptake of hemoglobin in renal proximal tubules. Both receptors were purified by use of hemoglobin-...

  1. Effects of hyperventilation and hypocapnic/normocapnic hypoxemia on renal function and lithium clearance in humans

    DEFF Research Database (Denmark)

    Christensen, H; Klausen, T; Fogh-Andersen, N;

    1998-01-01

    Using the renal clearance of lithium as an index of proximal tubular outflow, this study tested the hypothesis that acute hypocapnic hypoxemia decreases proximal tubular reabsorption to the same extent as hypocapnic normoxemia (hyperventilation) and that this response is blunted during normocapnic...

  2. Time-dependent clearance of mycophenolic acid in renal transplant recipients

    NARCIS (Netherlands)

    R.M. van Hest (Reinier); T. van Gelder (Teun); R. Bouw (René); T. Goggin (Timothy); R. Gordon (Robert); R. Mamelok (Richard); R.A. Mathot (Ron)

    2007-01-01

    textabstractAims: Pharmacokinetic studies of the immunosuppressive compound mycophenolic acid (MPA) have shown a structural decrease in clearance (CL) over time after renal transplantation. The aim of this study was to characterize the time-dependent CL of MPA by means of a population pharmacokineti

  3. The mechanism of increased renal clearance of amylase in acute pancreatitis.

    Science.gov (United States)

    Warshaw, A L; Lee, K H

    1976-09-01

    Amylase isoenzymes, separated by polyacrylamide gel electrophoresis, were measures in 25 normal persons (mean amylase to creatinine clearance ratio 3.0%), 15 patients with acute pancreatitis (mean clearance ratio 9.5%, P less than 0.0001), and 6 patients with hyperamylasemia due to common duct stones (mean clearance ratio 4.1%). Two isoamylases (P1, P2) resembling pancreatic isoenzymes and three isoamylases (S1, S2, S3) resembling salivary isoenzymes appeared regularly in normal serum and urine. Salivary amylases predominated in serum, but pancreatic amylases predominated in urine. This finding is consistent with renal clearance of pancreatic amylases exceeding that of salivary amylases under normal conditions. In patients with pancreatitis or common duct stones, essentially all of the increased amylase activity in serum and urine was due to pancreatic isoamylases (P1 and P2) in their normal proportions. No new or altered amylase isoenzymes were detected. The fraction of pancreatic amylases in the serum or urine was identical for the two diseases. Whereas the difference in amylase to creatinine clearance ratios observed between the two groups of patients is not a function of different amylase isoenzymes presented to the kidney, we conclude that the increased amylase clearance in acute pancreatitis is caused by an alteration of renal transfer of amylase, either at the glomerulus or tubule.

  4. Conventional measurements of GFR using 51Cr-EDTA overestimate true renal clearance by 10 percent

    International Nuclear Information System (INIS)

    It is widely believed that measurement of the area under the plasma clearance curve (AUC) following a single intravenous injection of chromium-51 labelled ethylene diamine tetra-acetic acid (51Cr-EDTA) is a gold standard method for determining glomerular filtration rate (GFR). However, there are reports that 51Cr-EDTA may have a significant extrarenal clearance. The aim of this study was to identify the non-renal component of 51Cr-EDTA plasma clearance contributing to the AUC measurement of GFR. Seventy healthy postmenopausal women (mean age 60 years, range 45-79 years) were injected with 3 MBq 51Cr-EDTA and 0.25 MBq iodine-125 labelled human serum albumin and 11 blood samples taken between 0 and 4 h through an indwelling venous cannula. For the first 21 subjects, two complete urine collections were made 0-2 h and 2-4 h after injection, and for the final 49 patients, four 1-h urine collections were made. The mean 51Cr-EDTA total plasma clearance was 84 ml/min (range 50-132 ml/min). The mean ratio (SEM) of urine to total clearance determined from the cumulative 1-, 2-, 3- and 4-h data was 0.903 (0.018), 0.891 (0.013), 0.898 (0.011) and 0.899 (0.010) respectively and remained constant despite the mean urine concentration decreasing from 122% to 15%/litre during this period. A least squares fit to data from the 238 individual urine collections was used to determine the fraction of the total plasma clearance attributable to renal clearance, α0, and the residual urine volume, ΔV. The results were α0=0.910 (95% CI: 0.889-0.932) and ΔV=14 ml (95% CI: -4 to +34 ml). The overestimation of the true renal clearance of 51Cr-EDTA by the AUC method is believed to be due to the failure of the plasma clearance curve to reach the true terminal exponential by 2 h after injection as usually assumed. As a result, conventional measurements of GFR using 51Cr-EDTA overestimate the true renal clearance of tracer by approximately 10%. (orig.)

  5. Macroamylasemia with a markedly increased amylase clearance ratio in a patient with renal cell carcinoma.

    Science.gov (United States)

    Kazmierczak, S C; Van Lente, F; McHugh, A M; Katzin, W E

    1988-02-01

    We report hyperamylasemia, macroamylasemia, and a markedly increased amylase clearance/creatinine clearance ratio in a patient with renal cell carcinoma. Serum amylase activity was characterized as macroamylase by gel exclusion chromatography. Electrophoretic separation revealed an atypical band of amylase, migrating anodal to the S2 control fraction. Electrophoresis of urine revealed the presence of both S1 and S2 fractions, but not the atypical band found in serum. Quantification of the salivary- and pancreatic-type amylase fractions showed amylase in urine to be 100% salivary. Immunofixation disclosed the macroamylase to consist of an immune complex between amylase and IgA-lambda antibody. Binding-capacity studies showed that the serum immunoglobulin was present in excess and could bind 46% and 49% additional S-type amylase activity derived from saliva and the patient's urine, respectively. The amylase clearance/creatinine clearance ratio was markedly supranormal (0.134), unexpected in a patient with macroamylasemia. A biopsy specimen of the renal cell tumor was found to contain significant salivary-type amylase activity. These results suggest production of amylase by tumor tissue in the renal carcinoma and secretion of S-type amylase into the patient's urine. Evidently, macroamylase should be confirmed by gel exclusion chromatography.

  6. Effect of glycation of albumin on its renal clearance in normal and diabetic rats

    International Nuclear Information System (INIS)

    Two independent techniques have been used to study the renal clearances of nonenzymatically glycated albumin and nonglycated albumin in normal and streptozotocin-induced diabetic rats, 16 to 24 weeks after the onset of diabetes. In the first technique, serum and urinary endogenous glycated and nonglycated albumin were separated using m-aminophenylboronate affinity chromatography and subsequently quantified by radioimmunoassay. Endogenous glycated albumin was cleared approximately twofold faster than nonglycated albumin in normal and diabetic rats. However, no difference was observed in the glycated albumin/nonglycated albumin clearance ratios (Cga/Calb) in normal and diabetic rats, respectively (2.18 +/- 0.39 vs 1.83 +/- 0.22, P greater than 0.05). The second technique measured the renal clearance of injected 125I-labelled glycated albumin and 125I-labelled albumin. The endogenous results were supported by the finding that 125I-labelled glycated albumin was cleared more rapidly than 125I-labelled albumin in normal (P less than 0.01) and diabetic (P less than 0.05) rats. The Cga/Calb ratio calculated for the radiolabelled albumins was 1.4 and 2.0 in normal and diabetic rats, respectively. This evidence suggests that nonenzymatic glycation of albumin increases its renal clearance to a similar degree in normal and diabetic rats

  7. Evaluation of circulating levels and renal clearance of natural amino acids in patients with Cushing's disease.

    Science.gov (United States)

    Faggiano, A; Pivonello, R; Melis, D; Alfieri, R; Filippella, M; Spagnuolo, G; Salvatore, F; Lombardi, G; Colao, A

    2002-02-01

    Although the hypercortisolism-induced impairment of protein homeostasis is object of several studies, a detailed evaluation of the complete amino acid profile of patients with Cushing's syndrome (CS) has never been performed. The aim of the current open transversal controlled study was to evaluate serum and urinary concentrations as well as renal clearance of the complete series of natural amino acids and their relationship with glucose tolerance in patients with Cushing's disease (CD). Twenty patients with CD (10 active and 10 cured) and 20 sex- and age-matched healthy controls entered the study. Measurement of serum and urinary levels of the complete series of natural amino acids was performed in all patients analyzed by cationic exchange high performance liquid cromatography (HPLC) after 2 weeks of a standardized protein intake regimen. The renal clearance (renal excretion rate) of each amino acid was calculated on the basis of the serum and urinary concentrations of creatinine and the specific amino acid. Fasting glucose and insulin levels, glucose and insulin response to standard glucose load, insulinogenic and homeostasis model insulin resistance (Homa-R) indexes were also evaluated and correlated to the circulating levels and renal clearances of each amino acid. Significantly higher serum (p<0.01) and urinary (p<0.05) levels of alanine and cystine, lower serum and higher urinary levels of leucine, isoleucine and valine (p<0.05) and higher renal excretion rates of leucine, isoleucine and valine (p<0.01) were found in patients with active CD than in patients cured from the disease and in controls. No difference was found between cured patients and controls. Creatinine clearance was similar in active and cured patients and in controls. In patients with active CD, urinary cortisol levels were significantly correlated to urinary cystine levels (r=0.85; p<0.01) and renal excretion rate of leucine (r=-0.76; p<0.05), isoleucine (r=-0.76; p<0.05) and valine (r=-0

  8. Renal Drug Dosage Adjustment According to Estimated Creatinine Clearance in Hospitalized Patients With Heart Failure.

    Science.gov (United States)

    Altunbas, Gokhan; Yazc, Mehmet; Solak, Yalcin; Gul, Enes E; Kayrak, Mehmet; Kaya, Zeynettin; Akilli, Hakan; Aribas, Alpay; Gaipov, Abduzhappar; Yazc, Raziye; Ozdemir, Kurtulus

    2016-01-01

    It is of clinical importance to determine creatinine clearance and adjust doses of prescribed drugs accordingly in patients with heart failure to prevent untoward effects. There is a scarcity of studies in the literature investigating this issue particularly in patients with heart failure, in whom many have impaired kidney function. The purpose of this study was to determine the degree of awareness of medication prescription as to creatinine clearance in patients hospitalized with heart failure. Patients hospitalized with a diagnosis of heart failure were retrospectively evaluated. Among screened charts, patients with left ventricular ejection fraction renal dose adjustment were determined and evaluated for appropriate dosing according to eGFR. A total of 388 patients with concomitant heart failure and renal dysfunction were included in the study. The total number of prescribed medications was 2808 and 48.3% (1357 medications) required renal dose adjustment. Of the 1357 medications, 12.6% (171 medications) were found to be inappropriately prescribed according to eGFR. The most common inappropriately prescribed medications were famotidine, metformin, perindopril, and ramipril. A significant portion of medications used in heart failure requires dose adjustment. Our results showed that in a typical cohort of patients with heart failure, many drugs are prescribed at inappropriately high doses according to creatinine clearance. Awareness should be increased among physicians caring for patients with heart failure to prevent adverse events related to medications.

  9. RENAL CLEARANCE AND URINARY EXCRETION OF KANAMYCIN IN DOMESTIC RUMINANT SPECIES

    Directory of Open Access Journals (Sweden)

    I. JAVED, Z. U. RAHMAN, F. H. KHAN, F. MUHAMMAD, Z. IQBAL AND B. ASLAM

    2006-01-01

    Full Text Available Species dependent geonetical differences in renal clearance and urinary excretion of kanamycin were investigated in adult female buffaloes, cows, sheep and goats. The drug was administered as a single intravenous dose (5 mg/kg b.wt. Blood and urine samples were collected at various time intervals after drug administration. The plasma and urine concentrations of the drug were determined using the microbiological assay. The mean (± SE values for endogenous creatinine clearance (an index of glomerular filtration rate were 0.77 ± 0.05, 0.49 ± 0.07, 0.81 ± 0.07 and 0.98 ± 0.13 ml/min.kg in buffaloes, cows, sheep and goats, respectively. Experiments regarding kidney handling of kanamycin in these ruminant species revealed respective values of renal clearance as 0.08 ± 0.01, 0.07 ± 0.01, 0.19 ± 0.02 and 0.23 ± 0.04 ml/min.kg. Besides glomerular filtration, kanamycin was reabsorbed from the renal tubules of all ruminant species and actively secreted into the renal tubules of buffaloes and goats. The cumulative percentages of intravenous dose of kanamycin excreted through urine during 12 hours in buffaloes, cows, sheep and goats were 4.31 ± 0.37, 2.53 ± 0.30, 11.0 ± 1.04 and 15.8 ± 2.22, respectively. This species variation in the percentage of urinary excretion in these domestic ruminants coincides with their respective glomerular filtration rates, being the highest in goats, lowest in cows and intermediate in sheep and buffaloes.

  10. Effects and outcome of Tamsulosin more than just stone clearance after extracorporeal shock wave lithotripsy for renal calculi

    International Nuclear Information System (INIS)

    Objective: To determine the effect of Tamsulosin, as adjunctive medical therapy after Extracorporeal Shock Wave Lithotripsy for renal stones on rate of stone clearance, clearance time, pain intensity during stone clearance, steinstrasse formation and auxiliary surgical intervention required. Method: A prospective randomized controlled study was carried out in 120 patients who underwent ESWL for renal stones of 0.5-2.0 cm. They were randomized into study and control group in which Tamsulosin 0.4mg/day was given in former as an adjunctive medical therapy. All patients underwent ESWL every 2 weeks until complete stone clearance for 8 weeks. The parameters assessed were stone clearance, clearance time, pain intensity and effect on steinstrasse. Results: Of the 120 patients 60 were in each group. The stone clearance rate was greater in study than in control group, 58(96.7%) vs. 48(80%) respectively, (p<0.004). The mean stone clearance time was observed earlier in study group as compared to control group with significant statistical difference in stone size between 0.6-1.5 cm. The mean intensity of pain patients experienced according to Visual analogue scale (VAS) was significantly less in study group (p<0.002). The rate of steinstrasse formation was observed to be higher in control than in study group 15(25%) vs 6(10%) respectively(p<0.003), while its spontaneous clearance was higher in study group than in control group 83.3% vs 33.3% (p<0.03). Conclusion: Tamsulosin significantly increases stone clearance after shock wave lithotripsy for renal stones. It also appeared to facilitate earlier stone clearance, reduces severity of pain, reduces the incidence of steinstrasse formation and tends to facilitate its spontaneous clearance. (author)

  11. Passing through the renal clearance barrier: toward ultrasmall sizes with stable ligands for potential clinical applications

    Directory of Open Access Journals (Sweden)

    Zhang XD

    2014-04-01

    Full Text Available Xiao-Dong Zhang,1 Jiang Yang,2 Sha-Sha Song,1 Wei Long,1 Jie Chen,1 Xiu Shen,1 Hao Wang,1 Yuan-Ming Sun,1 Pei-Xun Liu,1 Saijun Fan11Tianjin Key Laboratory of Molecular Nuclear Medicine, Institute of Radiation Medicine, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, People's Republic of China; 2Department of Biological Systems Engineering, University of Wisconsin-Madison, Madison, WI, USAAbstract: The use of nanoparticles holds promise for medical applications, such as X-ray imaging, photothermal therapy and radiotherapy. However, the in vivo toxicity of inorganic nanoparticles raises some concern regarding undesirable side effects which prevent their further medical application. Ultrasmall sub-5.5 nm particles can pass through the barrier for renal clearance, minimizing their toxicity. In this letter we address some recent interesting work regarding in vivo toxicity and renal clearance, and discuss the possible strategy of utilizing ultrasmall nanomaterials. We propose that small hydrodynamic sized nanoclusters can achieve both nontoxic and therapeutic clinical features.Keywords: in vivo clearance, gold nanoparticles, small size

  12. Quantitation of renal function with 99Tcm-DMSA. A comparison with creatinine clearance in children with single kidney.

    Science.gov (United States)

    Baillet, G; Gagnadoux, M F; De Vernejoul, P; Broyer, M

    1985-11-01

    To study the accuracy of renal function quantification with 99Tcm-DMSA we compared DMSA renal uptake and creatinine clearance in 16 cases of children with single kidney. The age of the patients ranged from two months to fourteen years. Creatinine clearance was normalized to 1.73 m2. DMSA uptake was measured 7 h after intravenous injection. Background subtraction was used and soft tissue attenuation was taken into account. The uptake was normalized in percentage of the injected activity. A significant correlation was found between creatinine clearance and DMSA uptake (rt = 0.866, p less than 0.01). Normal creatinine clearance range in children (80 to 120 ml min-1/1.73 m2) allowed determination of normal uptake range (36 to 60%). This study indicates that in case of asymmetrical renal impairment renal uptake will reflect split renal creatinine clearance. Since the former is much easier to measure, DMSA should play an important role in the evaluation of differential renal function.

  13. Effect of metabolic acidosis on renal tubular sodium handling in rats as determined by lithium clearance

    Directory of Open Access Journals (Sweden)

    Menegon L.F.

    1998-01-01

    Full Text Available Systemic metabolic acidosis is known to cause a decrease in salt and water reabsorption by the kidney. We have used renal lithium clearance to investigate the effect of chronic, NH4Cl-induced metabolic acidosis on the renal handling of Na+ in male Wistar-Hannover rats (200-250 g. Chronic acidosis (pH 7.16 ± 0.13 caused a sustained increase in renal fractional Na+ excretion (267.9 ± 36.4%, accompanied by an increase in fractional proximal (113.3 ± 3.6% and post-proximal (179.7 ± 20.2% Na+ and urinary K+ (163.4 ± 5.6% excretion when compared to control and pair-fed rats. These differences occurred in spite of an unchanged creatinine clearance and Na+ filtered load. A lower final body weight was observed in the acidotic (232 ± 4.6 g and pair-fed (225 ± 3.6 g rats compared to the controls (258 ± 3.7 g. In contrast, there was a significant increase in the kidney weights of acidotic rats (1.73 ± 0.05 g compared to the other experimental groups (control, 1.46 ± 0.05 g; pair-fed, 1.4 ± 0.05 g. We suggest that altered renal Na+ and K+ handling in acidotic rats may result from a reciprocal relationship between the level of metabolism in renal tubules and ion transport.

  14. [Evaluation of the renal function in type 2 diabetes: clearance calculation or cystatin C?].

    Science.gov (United States)

    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

  15. Iohexol plasma clearance, a simple and reliable method to measure renal function in conscious mice.

    Science.gov (United States)

    Luis-Lima, Sergio; Rodríguez-Rodríguez, Ana Elena; Martín-Higueras, Cristina; Sierra-Ramos, Catalina; Carrara, Fabiola; Arnau, María Rosa; Alvarez de la Rosa, Diego; Salido, Eduardo; Gaspari, Flavio; Porrini, Esteban

    2016-09-01

    In mice, renal function evaluated by serum creatinine has limitations. Gold standard methods using radioactive markers are cumbersome. We aimed to develop the iohexol plasma clearance as a simple assessment of renal function in conscious mice. We used two groups of mice: testing and validation, formed by 16 animals (8 male and 8 female) each. Iohexol was injected intravenously into the tail vein (6.47 mg), and tail tip blood samples were collected at 1, 3, 7, 10, 15, 35, 55, and 75 min. Iohexol plasma clearances were calculated in two ways: (1) two-compartment model (CL2) using all time points and (2) one-compartment model (CL1) using only the last four points. In the testing group, CL1 overestimated the true clearance (CL2). Therefore, CL1 was recalculated applying a correction factor calculated as the ratio between CL2/CL1. The latter was considered as the simplified method. CL2 averaged 223.3 ± 64.3 μl/min and CL1 252.4 ± 76.4 μl/min, which lead to a CF of 0.89. Comparable results for CL2, CL1, and simplified method were observed in the validation group. Additionally, we demonstrated the capacity of the simplified method to quantitatively assess different degrees of renal function in three mouse models: hyperoxaluric-CKD (87.4 ± 28.3 μl/min), heminephrectomized (135-0 ± 50.5 μl/min), and obese (399.6 ± 112.1 μl/min) mice. We have developed a simple and reliable method to evaluate renal function in conscious mice under diverse clinical conditions. Moreover, the test can be repeated in the same animal, which makes the method useful to examine renal function changes over time. PMID:27315812

  16. Lithium clearance and renal tubular sodium handling during acute and long-term nifedipine treatment in essential hypertension

    DEFF Research Database (Denmark)

    Bruun, N E; Ibsen, H; Skøtt, P;

    1988-01-01

    1. In two separate studies the lithium clearance method was used to evaluate the influence of acute and long-term nifedipine treatment on renal tubular sodium reabsorption. 2. In the acute study, after a 4 week placebo period two doses of 20 mg of nifedipine decreased supine blood pressure from 155...... of nifedipine treatment. As compared with placebo, mean supine blood pressure decreased significantly. The glomerular filtration rate did not change but lithium clearance fell by 30%. Consequently, the absolute and the fractional proximal sodium reabsorption increased significantly. The fractional distal sodium...... reabsorption did not change. Sodium clearance, fractional sodium excretion, potassium clearance, plasma volume and extracellular fluid volume were also unchanged. 4. In conclusion, we found no changes of renal tubular sodium reabsorption during acute nifedipine treatment, whereas long-term nifedipine treatment...

  17. Preliminary Diffusive Clearance of Silicon Nanopore Membranes in a Parallel Plate Configuration for Renal Replacement Therapy.

    Science.gov (United States)

    Kim, Steven; Heller, James; Iqbal, Zohora; Kant, Rishi; Kim, Eun Jung; Durack, Jeremy; Saeed, Maythem; Do, Loi; Hetts, Steven; Wilson, Mark; Brakeman, Paul; Fissell, William H; Roy, Shuvo

    2016-01-01

    Silicon nanopore membranes (SNMs) with compact geometry and uniform pore size distribution have demonstrated a remarkable capacity for hemofiltration. These advantages could potentially be used for hemodialysis. Here, we present an initial evaluation of the SNM's mechanical robustness, diffusive clearance, and hemocompatibility in a parallel plate configuration. Mechanical robustness of the SNM was demonstrated by exposing membranes to high flows (200 ml/min) and pressures (1,448 mm Hg). Diffusive clearance was performed in an albumin solution and whole blood with blood and dialysate flow rates of 25 ml/min. Hemocompatibility was evaluated using scanning electron microscopy and immunohistochemistry after 4 hours in an extracorporeal porcine model. The pressure drop across the flow cell was 4.6 mm Hg at 200 ml/min. Mechanical testing showed that SNM could withstand up to 775.7 mm Hg without fracture. Urea clearance did not show an appreciable decline in blood versus albumin solution. Extracorporeal studies showed blood was successfully driven via the arterial-venous pressure differential without thrombus formation. Bare silicon showed increased cell adhesion with a 4.1-fold increase and 1.8-fold increase over polyethylene glycol (PEG)-coated surfaces for tissue plasminogen factor (t-PA) and platelet adhesion (CD41), respectively. These initial results warrant further design and development of a fully scaled SNM-based parallel plate dialyzer for renal replacement therapy.

  18. Preliminary Diffusive Clearance of Silicon Nanopore Membranes in a Parallel Plate Configuration for Renal Replacement Therapy.

    Science.gov (United States)

    Kim, Steven; Heller, James; Iqbal, Zohora; Kant, Rishi; Kim, Eun Jung; Durack, Jeremy; Saeed, Maythem; Do, Loi; Hetts, Steven; Wilson, Mark; Brakeman, Paul; Fissell, William H; Roy, Shuvo

    2016-01-01

    Silicon nanopore membranes (SNMs) with compact geometry and uniform pore size distribution have demonstrated a remarkable capacity for hemofiltration. These advantages could potentially be used for hemodialysis. Here, we present an initial evaluation of the SNM's mechanical robustness, diffusive clearance, and hemocompatibility in a parallel plate configuration. Mechanical robustness of the SNM was demonstrated by exposing membranes to high flows (200 ml/min) and pressures (1,448 mm Hg). Diffusive clearance was performed in an albumin solution and whole blood with blood and dialysate flow rates of 25 ml/min. Hemocompatibility was evaluated using scanning electron microscopy and immunohistochemistry after 4 hours in an extracorporeal porcine model. The pressure drop across the flow cell was 4.6 mm Hg at 200 ml/min. Mechanical testing showed that SNM could withstand up to 775.7 mm Hg without fracture. Urea clearance did not show an appreciable decline in blood versus albumin solution. Extracorporeal studies showed blood was successfully driven via the arterial-venous pressure differential without thrombus formation. Bare silicon showed increased cell adhesion with a 4.1-fold increase and 1.8-fold increase over polyethylene glycol (PEG)-coated surfaces for tissue plasminogen factor (t-PA) and platelet adhesion (CD41), respectively. These initial results warrant further design and development of a fully scaled SNM-based parallel plate dialyzer for renal replacement therapy. PMID:26692401

  19. Creatinine clearance, urinary excretion of glomerular basement membrane antigens and renal histology in congenital nephrotic syndrome of Finnish type.

    Science.gov (United States)

    Huttunen, N P

    1977-04-01

    The endogenous creatinine clearance and urinary excretion rate of glomerular basement membrane (GBM) antigens were followed from 2 to 19 months in fifteen patients with congenital nephrotic syndrome (CNF). The quantitative examination of renal morphology was made on fourteen of these patients. Creatinine clearance increased during the first few months of life and thereafter gradually decreased. The urinary excretion rate of GBM antigens rose during the course of the disease. The creatinine clearance did not correlate significantly with glomerular fibrosis but it did correlate with tubular atrophy and interstitial fibrosis. The urinary excretion of GBM antigens correlated significantly with glomerular and interstitial fibrosis and with tubular atrophy. It is concluded that there is a clear progress in the disease and the renal histological changes probably are caused by accumulation of GBM material in glomeruli.

  20. Conventional measurements of GFR using {sup 51}Cr-EDTA overestimate true renal clearance by 10 percent

    Energy Technology Data Exchange (ETDEWEB)

    Moore, Amelia E.B.; Park-Holohan, So-Jin; Blake, Glen M.; Fogelman, Ignac [Department of Nuclear Medicine, Guy' s Hospital, St Thomas Street, London, SE1 9RT (United Kingdom)

    2003-01-01

    It is widely believed that measurement of the area under the plasma clearance curve (AUC) following a single intravenous injection of chromium-51 labelled ethylene diamine tetra-acetic acid ({sup 51}Cr-EDTA) is a gold standard method for determining glomerular filtration rate (GFR). However, there are reports that {sup 51}Cr-EDTA may have a significant extrarenal clearance. The aim of this study was to identify the non-renal component of {sup 51}Cr-EDTA plasma clearance contributing to the AUC measurement of GFR. Seventy healthy postmenopausal women (mean age 60 years, range 45-79 years) were injected with 3 MBq {sup 51}Cr-EDTA and 0.25 MBq iodine-125 labelled human serum albumin and 11 blood samples taken between 0 and 4 h through an indwelling venous cannula. For the first 21 subjects, two complete urine collections were made 0-2 h and 2-4 h after injection, and for the final 49 patients, four 1-h urine collections were made. The mean {sup 51}Cr-EDTA total plasma clearance was 84 ml/min (range 50-132 ml/min). The mean ratio (SEM) of urine to total clearance determined from the cumulative 1-, 2-, 3- and 4-h data was 0.903 (0.018), 0.891 (0.013), 0.898 (0.011) and 0.899 (0.010) respectively and remained constant despite the mean urine concentration decreasing from 122% to 15%/litre during this period. A least squares fit to data from the 238 individual urine collections was used to determine the fraction of the total plasma clearance attributable to renal clearance, {alpha}{sub 0}, and the residual urine volume, {delta}V. The results were {alpha}{sub 0}=0.910 (95% CI: 0.889-0.932) and {delta}V=14 ml (95% CI: -4 to +34 ml). The overestimation of the true renal clearance of {sup 51}Cr-EDTA by the AUC method is believed to be due to the failure of the plasma clearance curve to reach the true terminal exponential by 2 h after injection as usually assumed. As a result, conventional measurements of GFR using {sup 51}Cr-EDTA overestimate the true renal clearance of tracer

  1. Endogenous versus exogenous lithium clearance for evaluation of dopamine-induced changes in renal tubular function

    DEFF Research Database (Denmark)

    Olsen, Niels Vidiendal; Fogh-Andersen, N; Strandgaard, S;

    1996-01-01

    1. The present randomized, double-blind cross-over study compared endogenous and exogenous lithium clearance (CLi) for estimation of the effect of dopamine on tubular sodium reabsorption. Twelve normal, salt-repleted male subjects were investigated on three different occasions with either placebo...... or 450 mg or 600 mg of lithium given in random order at 22.00 hours. After an overnight fast, renal clearance studies were performed during a 1 h baseline period and subsequently during the second hour of an infusion of 3 micrograms min-1 kg-1 of dopamine. 2. Baseline values of endogenous CLi and...... fractional excretion of lithium (FELi) [27.0 (23.5-30.5) ml/min and 24.2 (20.3-28.2)% (means with 95% confidence interval)] were lower than exogenous values [lithium, 450 mg: 32.7 (29.9-35.4) ml/min (P <0.05) and 27.4 (25.2-29.6)% (P <0.05); lithium, 600 mg: 33.4 (29.2-37.6)ml/min (P <0.05) and 28.6 (26...

  2. Influence of amylase assay technique on renal clearance of amylase-creatinine ratio.

    Science.gov (United States)

    Levitt, M D; Johnson, S G; Ellis, C J; Engel, R R

    1977-06-01

    The influence of amylase assay technique on the renal amylase/creatinine clearance measurement was determined by analysis of serum and urine specimens obtained from 10 normal subjects. CAm/CCr averaged 2.19 +/- 0.18% with a saccharogenic technique, 1.52 +/- 0.2% with an iodometric technique, and 0.80 +/- 0.08% with a chromogenic technique. Each of these values differed significantly (P less than 0.05) from the other two. Recovery studies were carried out by adding partially purified human salivary or pancreatic amylase to human newborn serum or urine (which contain minimal endogenous amylase). Equal amylase activity was recovered from serum and urine by the saccharogenic technique whereas recovery from urine was less than 50% of that from serum using the iodometric and chromogenic techniques. The accuracy of the chromogenic technique is markedly improved by the addition of albumin to the urine assay system. Although it appears that only the saccharogenic method provides an accurate estimate of CAm/CCr, each assay technique distinguished the elevated CAm/CCr of patients with pancreatitis from the normal range established for that technique. Accurate clinical interpretation of CAm/CCr measurment requires knowledge of the amylase assay technique used.

  3. Renal clearance of digoxin in man after sodium loading or furosemide treatment.

    Science.gov (United States)

    Naafs, M A; van der Hoek, C; Schopman, W; van Duin, S; Koorevaar, G; Silberbusch, J

    1983-01-01

    To evaluate the influence of different types of natriuresis on the renal clearance of digoxin (Cldig) and the Cldig/Clcr ratio, studies were performed in which sodium-depleted patients were placed on a moderately high sodium diet for 6 days. In another group natriuresis was evoked by furosemide. In the first study, in 10 patients, there was a 10-fold increase in Na excretion and a small rise in diuresis (V) and Clcr, which was accompanied by an increase in Cldig from 57.5 +/- 32, and 60.7 +/- 27.3 (duplicate measurements) to 103.9 +/- 55.4 (p less than 0.01) and 103.8 +/- 46.5 ml min-1 (p less than 0.01). Cldig/Clcr rose from 0.60 +/- 0.24 and 0.61 +/- 0.16 to 0.91 +/- 0.31 and 0.91 +/- 0.21, respectively (both p less than 0.005). Serum digoxin concentration declined from 1.24 +/- 0.35 and 1.19 +/- 0.40 to 1.02 +/- 0.35 and 0.97 +/- 0.32 micrograms/l (both p less than 0.01) during the high sodium diet. In the furosemide-induced natriuresis (6 patients), changes in Na excretion and V were a multiple of those caused by Na loading, but the Cldig/Clcr ratio was not increased. The results are in accordance with the concept of digoxin backdiffusion in the proximal tubules, which is dependent on proximal Na reabsorption. In the more distal segments of the nephron, where the action of furosemide occurs, there does not appear to be any transtubular movement of digoxin. PMID:6628526

  4. A gene-gene interaction between polymorphisms in the OCT2 and MATE1 genes influences the renal clearance of metformin

    DEFF Research Database (Denmark)

    Hougaard Christensen, Mette Marie; Pedersen, Rasmus Steen; Stage, Tore Bjerregaard;

    2013-01-01

    The aim of this study was to determine the association between the renal clearance (CL(renal)) of metformin in healthy Caucasian volunteers and the single-nucleotide polymorphism (SNP) c.808G>T (rs316019) in OCT2 as well as the relevance of the gene-gene interactions between this SNP and (a...

  5. Influence of Renal Failure on Intestinal Clearance of Ciprofloxacin in Rats

    OpenAIRE

    Dautrey, Sophie; Rabbaa, Lydia; Laouari, Denise; Lacour, Bernard; Carbon, Claude; Farinotti, Robert

    1999-01-01

    Following intravenous doses, ciprofloxacin pharmacokinetics in control and nephrectomized rats were studied. There were no differences between control and nephrectomized rats for area under the concentration-time curve in plasma or biliary clearance. The intestinal clearance of ciprofloxacin was increased in nephrectomized rats. Intestinal elimination seems to compensate partially for the decrease in urinary excretion of ciprofloxacin in nephrectomized rats.

  6. [Evaluation of a modified exogenous creatinine clearance as a suitable renal function test for the small animal practice].

    Science.gov (United States)

    Höchel, Joachim; Finnah, Anke; Velde, Karsten; Hartmann, Helmut

    2004-01-01

    A suitable method in the routine veterinary practice for the quantitative determination of the glomerular filtration rate (GFR) in dogs and cats has not been available until to date. Therefore, we modified the known plasma clearance model (=P-CL). The resulting P-CLterminal was assessed concerning its diagnostic value. P-CL of exogenous creatinine (P-CLcrea) and of inulin were determined in dogs (n=12, Beagle, 6 months of age) and cats (n=11, Domestic Short Hair, 14 months of age). The marker substances were administered as a bolus injection. In fasted dogs, P-CLcrea was 84.3 +/- 14.85 ml/min/m2 after a creatinine dose of 2.4 g/m2. An electrolyte infusion during the clearance determination did not alter the resulting values (p>0.05). In fasted cats, P-CLcrea was 54.7 +/- 5.8 ml/min/m2 (creatinine dose 2.0 g/m2). The inulin clearance, determined at the same time, was 104.5 +/- 19.81 ml/min/m2. Feeding the cats just before and during the test increased P-CL of both markers significantly (pcats. An electrolyte infusion (dogs) and feeding (cats) had the same effect on P-CLterminal values as described above for P-CL. In conclusion,the modified exogenous creatinine clearance is a suitable renal function test for the early diagnosis of renal disease in dogs and cats presented in small animal practices. PMID:15495934

  7. Metabolic clearance of recombinant human growth hormone in health and chronic renal failure.

    OpenAIRE

    D. Haffner; Schaefer, F.; Girard, J.; Ritz, E.; Mehls, O

    1994-01-01

    Despite the increasing therapeutic use of recombinant human growth hormone (rhGH), its metabolic clearance has not been investigated in detail. To evaluate the kinetics of rhGH as a possible function of GH plasma concentration and glomerular filtration rate (GFR), we investigated the steady state metabolic clearance rate (MCR), disappearance half-life, and apparent volume of distribution of rhGH at low and high physiological as well as supraphysiological plasma GH levels during pharmacologica...

  8. Correlation between Creatinine Clearance and Transtubular Potassium Concentration Gradient in old people and chronic renal disease patients

    International Nuclear Information System (INIS)

    Senescence and chronic kidney disease (CKD) reduce progressively glomerular filtration rate (GFR) which usually results in an increase in potassium renal secretion. To evaluate whether the transtubular potassium concentration gradient (TTKG) is more accurate parameter for evaluating the renal secretion of this cation than using fractional excretion of potassium as its urinary secretion marker, we studied 55 subjects, 43 of them were healthy elderly volunteers and 12 were CKD patients. Exclusion criteria were: abnormal plasma potassium level or presence of any disease or drug that could induce alteration of balance of this electrolyte levels. All the subjects were on a diet with potassium content around 50 mmol/day. The curves, which demonstrate the relationship between creatinine clearance and TTKG and the grade of correlation between these two parameters were analyzed in both groups. We found that the transtubular potassium concentration gradient had a significant negative correlation with the creatinine clearance level in the healthy elderly group, while there was no correlation in the CKD group. (author)

  9. Renal clearance and extraction parameters of ortho-iodohippurate (I-123) compared with OIH(I-131) and PAH

    International Nuclear Information System (INIS)

    0-[131I]iodohippurate [OIH(I-131)] has been used for many years in the estimation of effective renal plasma flow. This compound suffers from low photon yield and poor images when the quantity used is limited to stay within a reasonable radiation dose. To test the validity of substituting I-123 for I-131, a series of experiments was performed in a surgically prepared dog model. The extraction ratios and clearance values 0IH(I-123) prepared from radionuclidically pure I-123 were compared with those of commercial OIH(I-131) and PAH. The extraction ratios for OIH(I-123) and OIH(I-131) were 0.65 and 0.67, representing 0.86 and 0.88 that of PAH, respectively. The clearance values (cc/min/kg) for the I-123 and I-131 compounds were almost identical (P = 0.77). Therefore OIH(I-123) can be used to estimate effective renal plasma flow; moreover, because of the high yield within an acceptable radiation dose range, images of good quality can be produced

  10. Augmented renal clearance implies a need for increased amoxicillin-clavulanic acid dosing in critically ill children.

    Science.gov (United States)

    De Cock, Pieter A J G; Standing, Joseph F; Barker, Charlotte I S; de Jaeger, Annick; Dhont, Evelyn; Carlier, Mieke; Verstraete, Alain G; Delanghe, Joris R; Robays, Hugo; De Paepe, Peter

    2015-11-01

    There is little data available to guide amoxicillin-clavulanic acid dosing in critically ill children. The primary objective of this study was to investigate the pharmacokinetics of both compounds in this pediatric subpopulation. Patients admitted to the pediatric intensive care unit (ICU) in whom intravenous amoxicillin-clavulanic acid was indicated (25 to 35 mg/kg of body weight every 6 h) were enrolled. Population pharmacokinetic analysis was conducted, and the clinical outcome was documented. A total of 325 and 151 blood samples were collected from 50 patients (median age, 2.58 years; age range, 1 month to 15 years) treated with amoxicillin and clavulanic acid, respectively. A three-compartment model for amoxicillin and a two-compartment model for clavulanic acid best described the data, in which allometric weight scaling and maturation functions were added a priori to scale for size and age. In addition, plasma cystatin C and concomitant treatment with vasopressors were identified to have a significant influence on amoxicillin clearance. The typical population values of clearance for amoxicillin and clavulanic acid were 17.97 liters/h/70 kg and 12.20 liters/h/70 kg, respectively. In 32% of the treated patients, amoxicillin-clavulanic acid therapy was stopped prematurely due to clinical failure, and the patient was switched to broader-spectrum antibiotic treatment. Monte Carlo simulations demonstrated that four-hourly dosing of 25 mg/kg was required to achieve the therapeutic target for both amoxicillin and clavulanic acid. For patients with augmented renal function, a 1-h infusion was preferable to bolus dosing. Current published dosing regimens result in subtherapeutic concentrations in the early period of sepsis due to augmented renal clearance, which risks clinical failure in critically ill children, and therefore need to be updated. (This study has been registered at Clinicaltrials.gov as an observational study [NCT02456974].).

  11. The role of plasma volume, plasma renin and the sympathetic nervous system in the posture-induced decline in renal lithium clearance in man.

    Science.gov (United States)

    Smith, D F; Shimizu, M

    1978-01-01

    Excretion of lithium in urine was studied in 2 healthy males while recumbent and while upright, either walking or standing quietly. An oral dose of 24.3 mmol of Lit was taken as three lithium carbonate tablets 13 h before clearance tests. Renal lithium clearance decreased and lithium fractional reabsorption increased while upright. Standing immersed to the neck in water, which prevents the fall in plasma volume upon changing posture from recumbent to upright, prevented the fall in renal lithium clearance as well as the rise in lithium fractional reabsorption while upright. Oral doses of guanethidine (total dose of 200 mg) or oxprenolol (total dose of 140 mg) taken to prevent high levels of sympathetic nervous system activity and plasma renin, respectively, failed to prevent the fall in renal lithium clearance or the rise in lithium fractional reabsorption upon changing posture from recumbent to upright. The findings indicate that the fall in renal lithium clearance and the rise in lithium fractional reabsorption upon changing posture from recumbent to upright is related to the fall in plasma volume but not to high levels of sympathetic nervous system activity or plasma renin activity.

  12. The role of plasma volume, plasma renin and the sympathetic nervous system in the posture-induced decline in renal lithium clearance in man.

    Science.gov (United States)

    Smith, D F; Shimizu, M

    1978-01-01

    Excretion of lithium in urine was studied in 2 healthy males while recumbent and while upright, either walking or standing quietly. An oral dose of 24.3 mmol of Lit was taken as three lithium carbonate tablets 13 h before clearance tests. Renal lithium clearance decreased and lithium fractional reabsorption increased while upright. Standing immersed to the neck in water, which prevents the fall in plasma volume upon changing posture from recumbent to upright, prevented the fall in renal lithium clearance as well as the rise in lithium fractional reabsorption while upright. Oral doses of guanethidine (total dose of 200 mg) or oxprenolol (total dose of 140 mg) taken to prevent high levels of sympathetic nervous system activity and plasma renin, respectively, failed to prevent the fall in renal lithium clearance or the rise in lithium fractional reabsorption upon changing posture from recumbent to upright. The findings indicate that the fall in renal lithium clearance and the rise in lithium fractional reabsorption upon changing posture from recumbent to upright is related to the fall in plasma volume but not to high levels of sympathetic nervous system activity or plasma renin activity. PMID:692834

  13. Determination of renal clearances of amylase/creatinine with chromogenic and enzymatic methods.

    Science.gov (United States)

    Hohenwallner, W; Wimmer, E; Sommer, R

    1979-12-01

    Urinary amylase was estimated by chromogenic (amylochrome Roche) as well as enzymatic methods (SKI and Beckman: substrate starch and substrate maltotetraose respectively). Random and timed urines (24 hour collections) were analysed. Clearances of amylase gave different results dependent upon the amylase-test used and the glomerular filtration rate. Correlation between chromogenic and enzymatic methods (starch as substrate) was poor. The ratio of amylase and creatinine clearance was used to test different methods. Reference values for this ratio for the amylochrome method (N = 106) were 2.85 +/- 0.99% and for the Beckman-DS method (N = 60) 2.82 +/- 0.87%.

  14. Avaliação renal de hipertensos pela clearance de creatinina num centro de saúde de Teresina-PI, Brasil Evaluación renal de hipertensos en el aclaramiento de creatinina en un centro sanitario de Teresina- PI, Brasil Evaluation of renal hypertensive by creatinine clearance in a health center in Teresina-pi, Brazil

    Directory of Open Access Journals (Sweden)

    Dinah Sá Rezende Neta

    2012-03-01

    Full Text Available A Hipertensão Arterial Sistémica é uma das principais causas de Insuficiência Renal Crónica. Estudo de abordagem quantitativa, desenvolvido no Centro de Saúde Porto Alegre e que teve como objetivo avaliar a função renal de pacientes com hipertensão pela clearance de creatinina, a partir da mensuração da creatinina sérica. Foi realizado levantamento de dados a partir de consultas de enfermagem e solicitados exames de creatinina sérica. Após o cálculo da clearance de creatinina pela equação de Cockcroft-Gault classificou-se os pacientes em um dos seis estágios da Doença Renal Crónica. Os resultados evidenciaram que 74% da amostra apresentou lesão renal, o que mostra o quanto é importante a avaliação periódica da função renal dos pacientes com hipertensão para que possam ser acompanhados quanto a progressão da Doença Renal Crónica.Hipertensión Arterial Sistémica es una de las principales causas de Insuficiencia Renal Crónica. Por ello, este estudio tuvo por objetivo evaluar la función renal de los pacientes con hipertensión por medio del aclaramiento de creatinina, a partir de la medición de la creatinina sérica. Estudio de enfoque cuantitativo, elaborado en el Centro de Salud de Porto Alegre. La recolección de datos ocurrió en consultas de enfermería y fueron se solicitaron pruebas de la creatinina sérica. Tras realizar el cálculo del aclaramiento de la creatinina mediante la fórmula Cockcroft-Gault, los pacientes fueron clasificados en una de las seis etapas de la Enfermedad Renal Crónica. Los resultados revelaron que 74% de la muestra presentaron daño renal, lo cual demuestra cuán importante es la evaluación periódica de la función renal de los pacientes con hipertensión para que se les pueda controlada la progresión de la Enfermedad Renal Crónica.Systemic arterial hypertension is a leading cause of chronic renal failure. Thus, this study aimed at assessing the renal function of patients with

  15. Clearance of glucoregulatory peptide hormones during haemodialysis and haemodiafiltration in non-diabetic end-stage renal disease patients

    DEFF Research Database (Denmark)

    Jørgensen, Morten B; Idorn, Thomas; Knop, Filip K;

    2015-01-01

    BACKGROUND: Patients with end-stage renal disease (ESRD) have increased fasting concentrations and disturbed postprandial responses of several glucoregulatory hormones. We aimed to evaluate the impact of high-flux haemodialysis (HD) and high-volume haemodiafiltration (HDF) on fasting...... and postprandial plasma levels of glucoregulatory pancreatic and gut peptide hormones in ESRD patients. METHODS: Ten non-diabetic HD-treated ESRD patients were included to undergo a 3-h standardized liquid mixed meal test 1 h into an HD and an HDF, respectively. On a third, optional, examination day, the meal test...... during HDF and four completed the optional meal test without dialysis. All plasma hormone concentrations declined significantly during the first fasting hour of dialysis with no differences between HD and HDF. Significant clearance of the investigated hormones was observed for both dialysis modalities...

  16. [Quantification of separate renal function using Tc 99m DTPA and Tc 99m DMSA. Correlations between individual isotopic data and creatinine clearance].

    Science.gov (United States)

    Chevet, D; Moisan, A; Le Pogamp, P; Le Cloirec, J; Wehbe, B; Herry, J Y

    1984-01-01

    The purpose of this prospective study (30 controls and 100 renal patients) is to compare one to each other the values of renal function measured with: 1--the DTPA 99mTc , 2--the DMSA 99mTc , and 3--the creatinine clearance. After the control values being established, correlations are done for the whole group (n = 130) between the creatinine clearance, the DTPA 99mTc clearance and the fixation rate of the DMSA 99mTc . The correlations obtained are:--Clcr Versus Cldtpa = 0,91.--Clcr Versus % Dmsa = 0,90. - Cldtpa Versus % Dmsa = 0,93. and indicate the two isotopic tests performed give similar quantitative results than creatinine clearance. Camera and computer allow to measure the separate renal function one by one, the two isotopic test giving similar values for each kidney. The results of these studies give a good concordance with the observed diseases, except for partial renal artery stenosis. The pyelic retention of DMSA 99mTc product, in condition of ureteral compression, gives a potential overestimation of this test and is a matter to debate. The extreme simplicity and facility of DMSA 99mTc procedures make this investigation accessible to any patient and give excellent morphological and functional tests. DTPA 99mTc clearances--global and separate kidney--give a more sensitive approach than DMSA 99mTc does because vascular captation , elimination rates could be focused. DTPA 99mTc procedure is to be used in patients with transplanted kidney, silent IVP kidney, contrast media contraindication or for exploring glomerular clearance without urine collection.

  17. Rapid blood clearance and lack of long-term renal toxicity of {sup 177}Lu-DOTATATE enables shortening of renoprotective amino acid infusion

    Energy Technology Data Exchange (ETDEWEB)

    Kashyap, Raghava; Eu, Peter [Centre for Cancer Imaging, Peter MacCallum Cancer Centre, Melbourne (Australia); Jackson, Price [Peter MacCallum Cancer Centre, Department of Physical Sciences, Melbourne (Australia); Hofman, Michael S.; Hicks, Rodney J. [Centre for Cancer Imaging, Peter MacCallum Cancer Centre, Melbourne (Australia); The University of Melbourne, Departments of Medicine and Radiology, Melbourne (Australia); Beauregard, Jean-Mathieu [Universite Laval, Department of Radiology, Quebec City (Canada); Zannino, Diana [Peter MacCallum Cancer Centre, Department of Biostatistics and Clinical Trials, Melbourne (Australia)

    2013-12-15

    The aim of the study was to investigate the feasibility of shortening the recommended 4-h renoprotective amino acid infusion in patients receiving peptide receptor chemoradionuclide therapy (PRCRT) using radiosensitizing 5-fluorouracil. We evaluated the clearance of radiopeptide from the blood, long-term nephrotoxicity in patients undergoing PRCRT with the conventional 4-h amino acid infusion and renal uptake in patients receiving an abbreviated infusion. The whole-blood clearance of {sup 177}Lu-DOTA-octreotate (LuTate) was measured in 13 patients receiving PRCRT. A retrospective analysis of short-term and long-term changes in glomerular filtration rate (GFR) in 96 consecutive patients receiving a 4-h infusion was performed. Renal LuTate retention estimated using quantitative SPECT/CT in 22 cycles delivered with a 2.5-h amino acid infusion was compared with that in 72 cycles with the 4-h infusion. LuTate demonstrated biexponential blood clearance with an initial clearance half-time of 21 min. Approximately 88 % of blood activity was cleared within 2 h. With the 4-h protocol, there was no significant change in GFR (1.2 ml/min mean increase from baseline; 95 % CI -6.9 to 4.4 ml/min) and no grade 3 or 4 nephrotoxicity at the end of induction PRCRT. The long-term decline in GFR after a median follow up of 22 months was 2.2 ml/min per year. There was no significant difference in the renal LuTate retention measured in patients receiving a 2.5-h amino acid infusion compared to those who had a 4-h infusion. The greatest renal exposure to circulating radiopeptide occurs in the first 1 - 2 h after injection. This, combined with the safety of LuTate PRCRT, allows consideration of an abbreviated amino acid infusion, increasing patient convenience and reducing human resource allocation. (orig.)

  18. Rapid blood clearance and lack of long-term renal toxicity of 177Lu-DOTATATE enables shortening of renoprotective amino acid infusion

    International Nuclear Information System (INIS)

    The aim of the study was to investigate the feasibility of shortening the recommended 4-h renoprotective amino acid infusion in patients receiving peptide receptor chemoradionuclide therapy (PRCRT) using radiosensitizing 5-fluorouracil. We evaluated the clearance of radiopeptide from the blood, long-term nephrotoxicity in patients undergoing PRCRT with the conventional 4-h amino acid infusion and renal uptake in patients receiving an abbreviated infusion. The whole-blood clearance of 177Lu-DOTA-octreotate (LuTate) was measured in 13 patients receiving PRCRT. A retrospective analysis of short-term and long-term changes in glomerular filtration rate (GFR) in 96 consecutive patients receiving a 4-h infusion was performed. Renal LuTate retention estimated using quantitative SPECT/CT in 22 cycles delivered with a 2.5-h amino acid infusion was compared with that in 72 cycles with the 4-h infusion. LuTate demonstrated biexponential blood clearance with an initial clearance half-time of 21 min. Approximately 88 % of blood activity was cleared within 2 h. With the 4-h protocol, there was no significant change in GFR (1.2 ml/min mean increase from baseline; 95 % CI -6.9 to 4.4 ml/min) and no grade 3 or 4 nephrotoxicity at the end of induction PRCRT. The long-term decline in GFR after a median follow up of 22 months was 2.2 ml/min per year. There was no significant difference in the renal LuTate retention measured in patients receiving a 2.5-h amino acid infusion compared to those who had a 4-h infusion. The greatest renal exposure to circulating radiopeptide occurs in the first 1 - 2 h after injection. This, combined with the safety of LuTate PRCRT, allows consideration of an abbreviated amino acid infusion, increasing patient convenience and reducing human resource allocation. (orig.)

  19. Eelvated postoperative renal clearance of amylase without pancreatitis after cardiopulmonary bypass.

    Science.gov (United States)

    Traverso, L W; Ferrari, B T; Buckberg, G D; Tompkins, R K

    1977-03-01

    Two postoperative cardiopulmonary bypass patients who had pancreatitis within a two week period provided the impetus for pursuing this study. Amylase-creatinine clearance ratios (ACCR) were measured in a series of ten thoracic surgery patients: six coronary artery bypass patients with cardiopulmonary bypass (cardiac group), and four exploratory thoracotomy patients (pulmonary group). These ratios were obtained in the preoperative, recovery room, and postoperative periods. Comparisons were made among the following data: clinical history, pre- and postoperative medications, intraoperative vital signs, drugs, and anesthetics. The preoperative mean ACCR was 3.34 per cent. All cardiac patients had a significantly elevated ACCR in the recovery room with a mean of 17.36 per cent (p less than 0.05). The ACCR had returned to preoperative levels by the second postoperative day in five of six cases. There were no elevated ACCR levels in the pulmonary group. All patients were asymptomatic for pancreatitis. The intraoperative course of the cardiac patients involved four common factors, besides cardiopulmonary bypass, which were not present in the pulmonary group. These similarities included transfusion of citrated fresh whole blood activated by calcium chloride, hypotension treated with ephedrine, administration of mannitol, and intraoperative morphine analgesia. The mechanisms of increased amylase secretion by calcium chloride or ephedrine administration and transient sphincter of Oddi constriction by morphine or the alpha-adrenergic response of ephedrine are considered with the theoretical implications toward pancreatitis. The background and significance of the ACCR are also analyzed, especially in association with the osmotic diuresis of mannitol and a subsequent low urine creatinine level. PMID:848659

  20. Detection of impaired renal function. Is the modern serologic marker cystatin C more accurate than the {sup 99m}Tc-MAG{sub 3} clearance?

    Energy Technology Data Exchange (ETDEWEB)

    Reinhardt, M.J.; Weidling, H.; Breuel, H.P.; Biersack, H.J. [Klinik und Poliklinik fuer Nuklearmedizin, Univ. Bonn (Germany)

    2004-12-01

    Aim: Real function is usually determined by means of creatinine-clearance, and of serum Cystatin C, the latter with increasing frequency. The present study analyses, whether the diagnostic accuracy of {sup 99m}Tc-MAG{sub 3} clearance is comparable to that of these modern serologic methods. Patients, methods: 71 consecutive adult Caucasian patients (42 female, 29 male; age 50{+-}16 yrs., range 20-83) who were referred to a nuclear medicine department for determination of bilateral renal function with {sup 99m}Tc-MAG{sub 3} were included. Following sufficient hydration, 10 ml of blood were taken for determination of Cystatin C and creatinine in serum prior to i.v. injection of the radiotracer. According to the recommendations of the National Kidney Foundation, glomerular filtration rate (GFR) was calculated form serum creatinine using either Cockcroft and Gault and Modification of Diet in Renal Disease (MDRD) study equation. These estimates of GFR served as reference. Cystatin C is a low molecular protein produced by all nuclear cells and is eliminated to 85% by glomerular filtration. Analysis of {sup 99m}Tc-MAG{sub 3} clearance was performed by means of Bubeck's formula. Results: Linear regression analysis produced Pearson's correlation coefficients of r=0.68 and r=-0.69 for the comparison of either Cystatin C and {sup 99m}Tc-MAG{sub 3} clearance with the Cockcroft and Gault equation. The comparison of Cystatin C and {sup 99m}Tc-MAG{sub 3} clearance with MDRD study equation resulted in correlation coefficients of r=0.755 and r=-0.77. None of these differences were significant. The exclusion of renal impairment or the detection of an at least moderate renal impairment revealed again no significant differences between Cystatin C and {sup 99m}Tc-MAG{sub 3} clearance. Conclusions: Cystatin C and {sup 99m}Tc-MAG{sub 3} clearance are equally suited to exclude renal impairment or to detect a relevant renal impairment. Differences between both procedures are more

  1. Changes in glomerular filtration rate, lithium clearance and plasma protein clearances in the early phase after unilateral nephrectomy in living healthy renal transplant donors

    DEFF Research Database (Denmark)

    Strandgaard, S; Kamper, A; Skaarup, P;

    1988-01-01

    1. Glomerular and tubular function was studied before and 2 months after unilateral nephrectomy in 14 healthy kidney donors by measurement of the clearances of 51Cr-labelled ethylenediaminetetra-acetate, lithium, beta 2-microglobulin, albumin and immunoglobulin G. 2. The glomerular filtration rate...

  2. The CYP3A4*22 C>T single nucleotide polymorphism is associated with reduced midazolam and tacrolimus clearance in stable renal allograft recipients.

    Science.gov (United States)

    de Jonge, H; Elens, L; de Loor, H; van Schaik, R H; Kuypers, D R J

    2015-04-01

    Tacrolimus, a dual substrate of CYP3A4 and CYP3A5 has a narrow therapeutic index and is characterized by high between-subject variability in oral bioavailability. This study investigated the effects of the recently described CYP3A4*22 intron 6 C>T single nucleotide polymorphism on in vivo CYP3A4 activity as measured by midazolam (MDZ) clearance and tacrolimus pharmacokinetics in two cohorts of renal allograft recipients, taking into account the CYP3A5*1/*3 genotype and other determinants of drug disposition. In CYP3A5 non-expressers, the presence of one CYP3A4*22T-allele was associated with a 31.7-33.6% reduction in MDZ apparent oral clearance, reflecting reduced in vivo CYP3A4 activity. In addition, at ⩾12 months after transplantation, steady-state clearance of tacrolimus was 36.8% decreased compared with homozygous CYP3A4*22CC-wild type patients, leading to 50% lower dose requirements. Both concurrent observations in stable renal allograft recipients are consistent with a reduced in vivo CYP3A4 activity for the CYP3A4*22T-allele.

  3. Challenges in Individualizing Drug Dosage for Intensive Care Unit Patients: Is Augmented Renal Clearance What We Really Want to Know? Some Suggested Management Approaches and Clinical Software Tools.

    Science.gov (United States)

    Jelliffe, Roger

    2016-08-01

    Acutely ill intensive care unit (ICU) patients often have large apparent volumes of distribution of drugs and, because of this, their drug clearance (CL) is usually also increased. 'Augmented renal Cl' is a current issue in the management of drug therapy for acutely ill and unstable ICU patients; however, Cl, the product of volume and the rate constant for excretion, describes only a theoretical volume of drug cleared per unit of time. Information of the actual rate of movement of the drug itself is obscured. It is suggested that the most useful clinical information is given by describing drug volume and elimination rate constant separately. This also permits better understanding of the patient's separate issues of fluid balance and drug elimination, especially when dialysis, renal replacement therapy, or extracorporeal membrane oxygenation (ECMO) may be used, and facilitates management of these two important separate clinical issues. Optimal management of drug therapy also requires optimal methods embodied in clinical software to describe drug behavior in these highly unstable patients, and considerably more data than for ordinary patients. The interacting multiple model (IMM) clinical software facilitates management of both fluid balance and drug therapy in these unstable patients. Illustrative cases are discussed, and new monitoring and management strategies are suggested. Like other ICU skills, physicians need to learn optimal tools for managing drug therapy in the ICU. Further work should help evaluate these new approaches. PMID:26914772

  4. Renal failure (chronic)

    OpenAIRE

    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...

  5. Radionuclide Renal Dynamic Imaging GFR (glomerular filtration rate) to Evaluate Renal Function and Serum Creatinine (Scre) Evaluation Comparison of Renal Clearance%核素肾动态显像GFR测定与肌酐清除率评价肾功能的相关性比较

    Institute of Scientific and Technical Information of China (English)

    张晓; 孙莲华

    2014-01-01

    Objective:To study radionuclide renal dynamic imaging GFR ( glomerular filtration rate ) to evaluate renal function and se-rum creatinine ( Scre) evaluation comparison of renal clearance .Methods:First estimation of normal reference value of my GFR in the control group;when renal function damage of 80 cases, measurement of GFR and creatinine clearance rate comparison of measurement val-ues.Results:80 cases patients of GFR and muscle anhydride cleared rate contrast , GFR and serum muscle anhydride are exception who 63 cases, its GFR value 81.3 ±12.8ml/min and muscle anhydride cleared rate 85.5 ±11.3ml/min, differences no significantly sexual meaning (P>0.05);12 cases chronic kidney damage patients , muscle anhydride cleared rate 70.1 ±8.3ml/min,GFR value 50.2 ± 6.8ml/min, differences has significantly sexual meaning ( P<0.01); Value of 5 patients with severe hydronephrosis GFR 19.1 ±7. 3ml/min, 23.6 ±5.8ml/min creatinine clearance rate, the difference has a significant meaning (P<0.01).Radionuclide renal dynam-ic values of GFR and creatinine clearance rate more in line with;early GFR and impaired renal function creatinine clearance rate of earlier abnormal changes .Conclusion:Radionuclide renal dynamic checking GFR determination can better reflect the change rate of Glomerular filtration function in early stage , a more accurate estimation of renal function .%目的:探讨放射性核素肾动态显像GFR(肾小球滤过率)评价肾功能与血清肌酐( Scre)清除率评价肾功能的比较。方法:首先对照组估算我科GFR的正常参考值;80例当肾功能受损害时,GFR的测量值与血清肌酐清除率测定值的比较。结果:80例患者的GFR与肌酐清除率对比,GFR和血清肌酐均异常者63例,其GFR值81.3±12.8ml/min与肌酐清除率85.5±11.3ml/min,差异无显著性意义(P>0.05);12例慢性肾损害患者,肌酐清除率70.1±8.3ml/min,GFR值50.2±6.8ml

  6. Lower metabolic clearance of tizanidine in Japanese subjects.

    Science.gov (United States)

    Momo, Kenji; Homma, Masato; Kohda, Yukinao

    2013-12-01

    Our aim was to determine whether metabolic clearance, renal clearance, or both elimination pathways contribute to ethnic differences in tizanidine clearance, which is ~ 2-fold higher in Caucasians than in Asians. The pharmacokinetic parameters of tizanidine in 9 healthy male Japanese subjects were compared with those of Caucasians in previous studies. Metabolic clearance of tizanidine was lower in Japanese than in Caucasian subjects (5.9 vs. 8.1 - 10.9 l/h/kg), although renal clearances were similar (0.040 vs. 0.047 - 0.055 l/h/kg). The results suggest that ethnic differences in tizanidine clearance are due to differences in metabolic clearance.

  7. Plasma Creatinine Clearance in the Dog

    Science.gov (United States)

    Frazier, Loy W.

    1977-01-01

    Lists materials and methods for an experiment that demonstrates the concept of glomerular filtration rate (GFR) using anesthesized dogs. In the dog, GFR is equivalent to the renal plasma clearance of exogenous creatinine. (CS)

  8. Lithium clearance in chronic nephropathy

    DEFF Research Database (Denmark)

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

    1989-01-01

    1. Lithium clearance measurements were made in 72 patients with chronic nephropathy of different aetiology and moderate to severely reduced renal function. 2. Lithium clearance was strictly correlated with glomerular filtration rate, and there was no suggestion of distal tubular reabsorption of...... lithium or influence of osmotic diuresis. 3. Fractional reabsorption of lithium was reduced in most patients with glomerular filtration rates below 25 ml/min. 4. Calculated fractional distal reabsorption of sodium was reduced in most patients with glomerular filtration rates below 50 ml/min. 5. Lithium...... lithium clearance may be a measure of the delivery of sodium and water from the renal proximal tubule. With this assumption it was found that adjustment of the sodium excretion in chronic nephropathy initially takes place in the distal parts of the nephron (loop of Henle, distal tubule and collecting duct...

  9. Reassessment of a classical single injection 51Cr-EDTA clearance method for determination of renal function in children and adults. Part I: Analytically correct relationship between total and one-pool clearance

    DEFF Research Database (Denmark)

    Jødal, Lars; Brøchner-Mortensen, Jens

    2009-01-01

    of the general form Cl = b·Cl1+c·Cl1² are usually used to estimate Cl from a measured Cl1. However, theoretical considerations indicate that such corrections underestimate Cl at high values. Aims. To derive an analytically correct relationship between Cl and Cl1 and determine the parameters involved for children......, a (minutes), not used for determination of Cl1, were measured. Results. The true relationship between Cl and Cl1 is given by Cl = Cl1/(1+f·Cl1), where f = a/PV. For men, women and children alike, the equation f = 0.0032·BSA-1.3 was applicable (BSA = body surface area in m²). Estimation errors on clearance...... and adults. Material and methods. Cl was determined in 149 subjects (M/F/children: 71/46/32) from a complete plasma concentration curve followed for 4-5 h after injection of 51Cr-EDTA (range of clearance: 8-183 mL/min/1.73 m²). Plasma volume, PV and the "missing" area under the plasma fraction curve...

  10. Glomerular filtration rate measured by 51Cr-EDTA clearance: evaluation of captopril-induced changes in hypertensive patients with and without renal artery stenosis

    Directory of Open Access Journals (Sweden)

    Anna Alice Rolim Chaves

    2010-01-01

    Full Text Available INTRODUCTION: Renal artery stenosis can lead to renovascular hypertension; however, the detection of stenosis alone does not guarantee the presence of renovascular hypertension. Renovascular hypertension depends on activation of the renin-angiotensin system, which can be detected by functional tests such as captopril renal scintigraphy. A method that allows direct measurement of the baseline and post-captopril glomerular filtration rate using chromium-51 labeled ethylenediamine tetraacetic acid (51Cr-EDTA could add valuable information to the investigation of hypertensive patients with renal artery stenosis. The purposes of this study were to create a protocol to measure the baseline and post-captopril glomerular filtration rate using 51Cr-EDTA, and to verify whether changes in the glomerular filtration rate permit differentiation between hypertensive patients with and without renal artery stenosis. METHODS: This prospective study included 41 consecutive patients with poorly controlled severe hypertension. All patients had undergone a radiological investigation of renal artery stenosis within the month prior to their inclusion. The patients were divided into two groups: patients with (n=21 and without renal artery stenosis, (n=20. In vitro glomerular filtration rate analysis (51Cr-EDTA and 99mTc-DMSA scintigraphy were performed before and after captopril administration in all patients. RESULTS: The mean baseline glomerular filtration rate was 48.6±21.8 ml/kg/1.73 m² in the group wuth renal artery stenosis, which was significantly lower than the GFR of 65.1±28.7 ml/kg/1.73m² in the group without renal artery stenosis (p=0.04. Captopril induced a significant reduction of the glomerular filtration rate in the group with renal artery stenosis (to 32.6±14.8 ml/kg/1.73m², p=0.001 and an insignificant change in the group without RAS (to 62.2±23.6 ml/kg/1.73m², p=0.68. Scintigraphy with technetium-99m dimercapto-succinic acid (DMSA did not show

  11. Glomerular filtration rate measured by {sup 51}Cr-EDTA clearance: evaluation of captopril-induced changes in hypertensive patients with and without renal artery stenosis

    Energy Technology Data Exchange (ETDEWEB)

    Chaves, Anna Alice Rolim; Buchpiguel, Carlos Alberto; Praxedes, Jose Nery; Bortolotto, Luiz Aparecido; Sapienza, Marcelo Tatit, E-mail: annaalice100@yahoo.com.b [Universidade de Sao Paulo (USP), SP (Brazil). Faculdade de Medicina. Dept. de Neurologia

    2010-07-01

    Introduction: renal artery stenosis can lead to renovascular hypertension; however, the detection of stenosis alone does not guarantee the presence of renovascular hypertension. Renovascular hypertension depends on activation of the renin-angiotensin system, which can be detected by functional tests such as captopril renal scintigraphy. A method that allows direct measurement of the baseline and post-captopril glomerular filtration rate using chromium-51 labeled ethylenediamine tetraacetic acid ({sup 51}Cr-EDTA) could add valuable information to the investigation of hypertensive patients with renal artery stenosis. The purposes of this study were to create a protocol to measure the baseline and post-captopril glomerular filtration rate using {sup 51}Cr-EDTA, and to verify whether changes in the glomerular filtration rate permit differentiation between hypertensive patients with and without renal artery stenosis. Methods: this prospective study included 41 consecutive patients with poorly controlled severe hypertension. All patients had undergone a radiological investigation of renal artery stenosis within the month prior to their inclusion. The patients were divided into two groups: patients with (n=21) and without renal artery stenosis, (n=20). In vitro glomerular filtration rate analysis ({sup 51}Cr-EDTA) and {sup 99m}Tc-DMSA scintigraphy were performed before and after captopril administration in all patients. Results: the mean baseline glomerular filtration rate was 48.6+-21.8 ml/kg/1.73 m{sup 2} in the group with renal artery stenosis, which was significantly lower than the GFR of 65.1+-28.7 ml/kg/1.73m{sup 2} in the group without renal artery stenosis (p=0.04). Captopril induced a significant reduction of the glomerular filtration rate in the group with renal artery stenosis (to 32.6+-14.8 ml/kg/1.73m{sup 2}, p=0.001) and an insignificant change in the group without RAS (to 62.2+-23.6 ml/kg/1.73m{sup 2}, p=0.68). Scintigraphy with technetium-99m dimercapto

  12. Evaluation of the efficacy of tamsulosin with or without deflazacort for stone clearance after extracorporeal shockwave lithotripsy for upper ureteral and renal calculi

    Directory of Open Access Journals (Sweden)

    Rajeev T. P.

    2016-02-01

    Conclusions: Addition of alpha-blocker tamsulosin along with deflazacort post ESWL for renal and upper ureteric calculi increases the stone expulsion rate and reduces the expulsion duration as shown by highly statistically significant results in group C. [Int J Res Med Sci 2016; 4(2.000: 643-648

  13. Evaluation of {sup 123}I-orthoiodohippurate single kidney clearance rate by renal sequential scintigraphy in a large cohort of likely normal subjects aged between 0 and 18 years

    Energy Technology Data Exchange (ETDEWEB)

    Imperiale, Alessio; Olianti, Catia; Comis, Giannetto; Cava, Giuseppe la [University of Florence, Nuclear Medicine Unit, Department of Clinical Pathophysiology, Florence (Italy)

    2006-12-15

    Age-related values of{sup 123}I-orthoiodohippurate (OIH) single kidney clearance rate (Cl) were estimated in a large cohort of likely normal children aged between 0 and 18 years. Among 4,111 children examined in the past 10 years, 917 were selected with the following inclusion criteria: (a) mild ultrasonographic hydronephrosis with right differential renal function (DRF) <53% and >47% (498 pts), (b) known or suspected urinary tract infection with normal ultrasound, serum creatinine and DMSA and DRF <53% and >47% (419 pts).{sup 123}I-OIH-Cl was assessed using a validated gamma camera method. Children were divided into 21 age classes: from 0 to 2 years, eight 3-month classes; from 2 to 14 years, twelve 1-year classes; from 14 to 18 years, one 4-year class. Cl, plotted against age, was fitted using an increasing function (y = a - be - cx). Mean{sup 123}I-OIH-Cl of 1,834 kidneys was 306{+-}22 ml/min/1.73 m{sup 2} BSA. Mean{sup 123}I-OIH-Cl of the right and left kidneys was 307{+-}23 and 305{+-}22 ml/min/1.73 m{sup 2} BSA, respectively (p<0.002). The best-fitting{sup 123}I-OIH-Cl growing function was: Cl=311-230e-0.69 x Age (months).{sup 123}I-OIH-Cl improved progressively starting from birth, reaching 96% and 98% of the mature value at 1 and 1.5 years, respectively.{sup 123}I-OIH-Cl at birth (age=0) was 81 ml/min/1.73 m{sup 2} BSA. After 18.6 days of life, the renal function had doubled its starting value, and it reached a plateau of 311 ml/min/1.73 m{sup 2} BSA at 2 years. This work represents a systematic evaluation of ERPF by a gamma camera method in a large cohort of selected likely normal paediatric subjects. (orig.)

  14. Enhancement of the amylase-creatinine clearance ratio in pregnancy.

    Science.gov (United States)

    Naeije, R; Neuray, F; Van Melsen, A; Delcourt, A

    1979-01-01

    The renal clearance of amylase, expressed as a proportion of simultaneous creatinine clearance (Cam/-Ccr), was determined in 131 women in various stages of pregnancy. No abnormal serum levels of amylase were found. A moderate but significant increase in Cam/Ccr occurred during the last 15 weeks of pregnancy. Possible causes for this change were investigated in smaller groups of subjects. No increase in rapidly cleared isoamylase could be detected. No modification in renal tubular handling of protein could be evidenced, as assessed by measurements of the renal clearance of beta 2 microglobulin, expressed as a proportion of simultaneous creatinine clearance. An incrased glomerular permeability to amylase probably accounts for elevated Cam/Ccr in pregnancy.

  15. Security Clearance Tracking System

    Data.gov (United States)

    National Archives and Records Administration — SCTS supports the adjudication process of private background investigations and clearances for potential employees, contractors, interns and student workers.

  16. Renal arteriography

    Science.gov (United States)

    Renal angiogram; Angiography - kidney; Renal angiography; Renal artery stenosis - arteriography ... Renal arteriography is often needed to help decide on the best treatment after other tests are done ...

  17. No effect of dietary fish oil on renal hemodynamics, tubular function, and renal functional reserve in long-term renal transplant recipients

    DEFF Research Database (Denmark)

    Hansen, J M; Løkkegaard, H; Høy, Carl-Erik;

    1995-01-01

    Dietary supplementation with fish oil rich in n-3 polyunsaturated fatty acids has been suggested to protect the kidney against cyclosporin A (CsA) toxicity. This study investigated the effects of a 10-wk dietary supplementation with fish oil on renal function and renal functional reserve in healthy...... and effective RPF were measured as the renal clearances of (99mTc)DTPA and (131I)hippuran, respectively. Renal tubular function was evaluated by use of the renal clearance of lithium and the urinary excretion of beta 2-microglobulin. Fish oil did not change baseline values of effective RPF, GFR, lithium...... clearance, and urinary excretion of beta 2-microglobulin in any of the groups. The infusion of amino acids induced a comparable increase in GFR, lithium clearance, and the urinary excretion rate of beta 2-microglobulin in all three groups with no additional effect of fish oil. Thus, long-term renal...

  18. [Radioisotopic quantification of kidney function using Tc-99m-DMSA. Comparison with creatinine clearance in children with a single kidney].

    Science.gov (United States)

    Baillet, G; Gagnadoux, M F; Mathonnat, F; de Vernejoul, P; Broyer, M

    1986-01-01

    To assess the accuracy of renal function quantification with Tc 99m-DMSA in children, we compared DMSA renal uptake and creatinine clearance in 16 cases of children with single kidney. The age of the patients ranged from two month to fourteen years. DMSA renal uptake was measured 7 hours after injection and was normalized in percent of the injected activity. A significant correlation was found between creatinine clearance and DMSA uptake (Pearson's r = 0.866, p less than 0.01). Normal creatinine clearance in children (80 to 120 ml/min-1 X 1.73 m-2) allowed determination of normal renal uptake (36 to 60%). This study indicates that in cases of asymmetrical renal impairment renal uptake reflects split renal creatinine clearance. Since the former is much easier to measure, DMSA should play an important role in the evaluation of differential renal function.

  19. Effect of sludge ice cooling on renal function and renal histology in the dog.

    Science.gov (United States)

    Verbaeys, A; Oosterlinck, W; Lameire, N; Cuvelier, C; De Sy, W A

    1981-01-01

    The effect of sludge ice surface cooling on the compensatory hypertrophied dog kidney was investigated. Renal function was measured prior to and on days 1, 3 and 7 after the cooling procedure by means of inulin clearance, PAH clearance and sodium excretion capacity during normal hydration and after volume expansion. No alteration in renal function was shown. No freezing lesions or thromboses were seen on histological examination.

  20. Generic Clearance Values

    International Nuclear Information System (INIS)

    This paper analyzes the Generic Clearance Values established for natural and artificial radionuclides with the objective of evaluating their degree of conservatism in views of adopting them into the regulatory body. Generic clearance values for natural radionuclides have been chosen by experts judgments as the optimum boundary between, on the one hand, the ubiquitous unmodified soil concentrations and, on the other hand, activity concentrations in ores, mineral sands, industrial residues and wastes. For artificial radionuclides the clearance levels have been derived from the scenarios postulated in the document Safety Reports Series 44 of the IAEA considering quantitative exemption criteria. A set of 8 scenarios were postulated covering external, ingestion and inhalation exposure pathways. For each radionuclide, the generic clearance level was derived as the more restrictive value obtained from the scenarios, that is the lowest ratio between the applicable individual dose and the dose per unit activity concentration (Bq/g). The individual dose was calculated by a formula depending on each scenario and pathway, with different parameters, such as exposure time, dosimetric factors, dilution factor, density of the material, geometric factors, etc. It was concluded that the basis and parameters used for the derivation of the generic clearance levels are quite conservative and therefore its the adoption in Argentina has been recommended. It is expected that their implementation will contribute to optimize the regulatory management system. (authors)

  1. The effect of nifedipine on renal function in normotensive cyclosporin-A-treated renal allograft recipients.

    Science.gov (United States)

    McNally, P G; Walls, J; Feehally, J

    1990-01-01

    Intrarenal vasoconstriction is a characteristic feature of CsA nephrotoxicity. The influence of nifedipine, a dihydropyridine calcium channel blocker and potent renal vasodilator, on renal haemodynamics was investigated in 11 cyclosporin A (CsA)- and 9 azathioprine (Aza)-treated normotensive long-term renal allograft recipients. Baseline Cr51-EDTA clearance and effective renal plasma flow (ERPF) were similar in both groups. Nifedipine 20 mg twice daily for 28 days significantly increased Cr51-EDTA clearance (+14.8%) in the CsA group; however, ERPF, renal vascular resistance (RVR), and filtration fraction did not change. Nifedipine did not influence renal haemodynamics in the azathioprine group. The increase in Cr51-EDTA clearance in the CsA group did not correlate with baseline renal function, CsA dose or whole blood levels, donor age, duration of graft, or renal functional reserve capacity. This study suggests that nifedipine confers a beneficial effect on renal haemodynamics in long-term CsA-treated renal allograft recipients and appears to improve renal function by a non-haemodynamic mechanism.

  2. Comparison of 99mTc-DTPA GFR and 99mTc-DTPA Renal Clearance%肾动态体外摄取法GFR与99mTc-DTPA肾清除率的对比研究

    Institute of Scientific and Technical Information of China (English)

    齐慧敏; 辛岗; 张春丽; 李驚子; 邓丽荣; 王海燕

    2002-01-01

    Objective To evaluate the two methods in GFR measurements. Methods By using Receiver Operating Characteristic (ROC) curve, likelihood ratio and regression analysis we compared 99mTc- DTPA GFR with clearance of 99mTc-DTPA (CL 99mTc). Results The 99mTc - DTPA GFR mean area under ROC curve was 0.79 mean sensitivity was 62%, mean specificity was 83.8%, r = 0.78, regression formula was Y = 8.5 + 0.76X. Conclusion The accuracy of 99mTc - DTPA was not so good.

  3. RENAL AND MUSCULAR DYSFUNCTION IN SUBCLINICAL HYPOTHYROIDISM

    OpenAIRE

    Mohammed Ali; Sushith; Prathima; Reshma; Madan Gopal; Francis. N. P.

    2015-01-01

    BACKGROUND: Hypothyroidism may result in alteration in renal and muscular functioning resulting in renal failure and myopathies. This study adds to existing literature emphasizing the utility of periodic assessment of renal parameters and creatine kinase in hypothyroid patients. AIM: The aims of this study were to compare parameters of serum creatinine, creatinine clearance and serum creatine kinase in subclinical hypothyroid cases. MATERIALS AND METHODS: This case control...

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

    Directory of Open Access Journals (Sweden)

    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.

  5. Mucociliary clearance in chronic sinusitis

    OpenAIRE

    Birdi, Surinder Mohan; Singh, Sunder; Singh, Ajit

    1998-01-01

    Mucociliary clearance is an important defence mechanism of upper and lower respiratory tracts. Any disturbance in the mechanism leads to stagnation of secretions and secondary infection with prolonged mucociliary clearance time. The present study was undertaken to establish normal mucociliary clearance time in our region and to evaluate its diagnostic and prognostic potential in chronic sinusitis of variable duration with and without obstructive diseases.

  6. The influence of body posture on lithium clearance

    DEFF Research Database (Denmark)

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

    1988-01-01

    fall in the sitting position, and fell significantly to 26 +/- 5 ml/min (p less than 0.025) in walking subjects. Absolute proximal tubular reabsorption rate of fluid correspondingly rose from 83 +/- 16 to 92 +/- 15 ml/min (p less than 0.005) and sodium clearance fell from 1.52 +/- 0.81 to 1.00 +/- 0...... during moderate physical activity. Hence, when renal tubular function is studied with the lithium clearance method, standardization of posture and physical activity is important. In such studies physical activity such as walking should particularly be avoided....

  7. I-131 HIPPURAN FOR THE ESTIMATION OF RENAL PLASMA-FLOW - REQUIREMENTS FOR RADIOCHEMICAL PURITY

    NARCIS (Netherlands)

    KENGEN, RAM; MEIJER, S; VANZANTEN, AK; BEEKHUIS, H; KOSTERINK, JGW; PIERS, DA

    1995-01-01

    For many years iodide-131 Hippuran has been used as a tracer to measure effective renal plasma flow (ERPF). Because of the low renal clearance of free I-131-iodide and the inability to count it separately from I-131-Hippuran, free I-131-iodide will lower the calculated I-131-Hippuran clearance, resu

  8. Trauma renal Renal trauma

    Directory of Open Access Journals (Sweden)

    Gerson Alves Pereira Júnior

    1999-02-01

    Full Text Available Apresentamos uma revisão sobre trauma renal, com ênfase na avaliação radiológica, particularmente com o uso da tomografia computadorizada, que tem se tornado o exame de eleição, ao invés da urografia excretora e arteriografia. O sucesso no tratamento conservador dos pacientes com trauma renal depende de um acurado estadiamento da extensão da lesão, classificado de acordo com a Organ Injury Scaling do Colégio Americano de Cirurgiões. O tratamento conservador não-operatório é seguro e consiste de observação contínua, repouso no leito, hidratação endovenosa adequada e antibioti- coterapia profilática, evitando-se uma exploração cirúrgica desnecessária e possível perda renal. As indicações para exploração cirúrgica imediata são abdome agudo, rápida queda do hematócrito ou lesões associadas determinadas na avaliação radiológica. Quando indicada, a exploração renal após controle vascular prévio é segura, permitindo cuidadosa inspeção do rim e sua reconstrução com sucesso, reduzindo a probabilidade de nefrectomia.We present a revision of the renal trauma with emphasis in the radiographic evaluation, particularly CT scan that it has largely replaced the excretory urogram and arteriogram in the diagnostic worh-up and management of the patient with renal trauma. The successful management of renal injuries depends upon the accurate assessment of their extent in agreement with Organ Injury Scaling classification. The conservative therapy managed by careful continuous observation, bed rest, appropriate fluid ressuscitation and prophylactic antibiotic coverage after radiographic staging for severely injured kidneys can yield favorable results and save patients from unnecessary exploration and possible renal loss. The indications for immediate exploratory laparotomy were acute abdomen, rapidly dropping hematocrit or associated injuries as determinated from radiologic evaluation. When indicated, renal exploration

  9. The clearance concept with special reference to determination of glomerular filtration rate in patients with fluid retention

    DEFF Research Database (Denmark)

    Henriksen, Ulrik L; Henriksen, Jens H

    2014-01-01

    In subjects without fluid retention, the total plasma clearance of a renal filtration indicator (inulin, (99m) Tc-DTPA, (51) Cr-EDTA) is close to the urinary plasma clearance. Conversely, in patients with fluid retention (oedema, pleural effusions, ascites), there is a substantial discrepancy...

  10. Site clearance working group

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1997-03-01

    The Gulf of Mexico and Louisiana continue to be areas with a high level of facility removal, and the pace of removal is projected to increase. Regulations were promulgated for the Gulf of Mexico and Louisiana requiring that abandoned sites be cleared of debris that could interfere with fishing and shrimping activities. The site clearance regulations also required verification that the sites were clear. Additionally, government programs were established to compensate fishermen for losses associated with snagging their equipment on oil and gas related objects that remained on the water bottoms in areas other than active producing sites and sites that had been verified as clear of obstructions and snags. The oil and gas industry funds the compensation programs. This paper reviews the regulations and evolving operating practices in the Gulf of Mexico and Louisiana where site clearance and fisherman`s gear compensation regulations have been in place for a number of years. Although regulations and guidelines may be in place elsewhere in the world, this paper focuses on the Gulf of Mexico and Louisiana. Workshop participants are encouraged to bring up international issues during the course of the workshop. Additionally, this paper raises questions and focuses on issues that are of concern to the various Gulf of Mexico and Louisiana water surface and water bottom stakeholders. This paper does not have answers to the questions or issues. During the workshop participants will debate the questions and issues in an attempt to develop consensus opinions and/or make suggestions that can be provided to the appropriate organizations, both private and government, for possible future research or policy adjustments. Site clearance and facility removal are different activities. Facility removal deals with removal of the structures used to produce oil and gas including platforms, wells, casing, piles, pipelines, well protection structures, etc.

  11. 间苯三酚应用时机对行输尿管镜钬激光碎石术后结石清除率及肾绞痛的影响%Influence of Opportune Administration of Phloroglucinol on Stone Clearance Rate and Renal Colic After Ureteroscopic Holmium Laser Lithotripsy

    Institute of Scientific and Technical Information of China (English)

    吴友科; 刘绍勇; 黄少行; 陈雁威

    2016-01-01

    目的 探讨间苯三酚应用时机对输尿管镜钬激光碎石术后结石清除率及肾绞痛的影响. 方法 选择2013年1月至2014年12月在我院治疗的输尿管结石患者100例, 随机分为观察组和对照组, 每组50例. 两组患者均进行输尿管镜钬激光碎石术治疗, 观察组于碎石前15 min应用静脉滴注间苯三酚治疗, 而对照组于碎石后15 min应用静脉滴注间苯三酚治疗, 对两组患者的排石效果及肾绞痛等并发症的发生情况进行比较分析. 结果 观察组排石总有效率为94.0%, 显著高于对照组的78.0%; 观察组的碎石成功率及结石清除率分别为96.0%、 92.0%, 显著高于对照组的82.0%、 74.0%; 观察组的排石所需时间为 (5.5 ± 2.0) h, 显著少于对照组的 ( 9.4 ± 3.1) h; 观察组在随访期间的肾绞痛缓解率及再发率分别为94.0%、 2.0%, 对照组为76.0%、14.0%; 以上指标组间比较差异均有统计学意义 (P<0.05). 结论 输尿管镜钬激光碎石术前15 min静脉滴注间苯三酚, 不仅能有效促进结石的排出, 提高结石清除率, 还能明显缓解肾绞痛的程度, 降低肾绞痛的再发率, 同时不增加治疗后的不良反应.%Objective To explore the influence of opportune administration of phloroglucinol on stone clearance rate and renal colic after ureteroscopic holmium laser lithotripsy. Methods 100 cases of ureteral calculi were selected and randomly divided into two groups equally. All patients received ureteroscopic holmium laser lithotripsy. The observation group received phloroglucinol 15 min before lithotripsy, while the control group received phloroglucinol 15 min after lithotripsy. The result of calculi discharging and incidence of renal colic were compared between the two groups. Results The total effective rate of calculi discharging, success rate of lithotripsy, and stone clearance rate of the observation group were 94.0%, 96.0%and 92.0%respectively, significantly higher than 78

  12. Mathematical modeling and analysis of insulin clearance in vivo

    OpenAIRE

    Koschorreck, Markus; Gilles, Ernst Dieter

    2008-01-01

    Background Analyzing the dynamics of insulin concentration in the blood is necessary for a comprehensive understanding of the effects of insulin in vivo. Insulin removal from the blood has been addressed in many studies. The results are highly variable with respect to insulin clearance and the relative contributions of hepatic and renal insulin degradation. Results We present a dynamic mathematical model of insulin concentration in the blood and of insulin receptor activation in hepatocytes. ...

  13. Mathematical modeling and analysis of insulin clearance in vivo

    OpenAIRE

    Koschorreck, M.; Gilles, E. D.

    2008-01-01

    Background: Analyzing the dynamics of insulin concentration in the blood is necessary for a comprehensive understanding of the effects of insulin in vivo. Insulin removal from the blood has been addressed in many studies. The results are highly variable with respect to insulin clearance and the relative contributions of hepatic and renal insulin degradation. Results: We present a dynamic mathematical model of insulin concentration in the blood and of insulin receptor acti...

  14. Mathematical modeling and analysis of insulin clearance in vivo

    OpenAIRE

    Koschorreck, M.; Gilles, E.

    2008-01-01

    Background: Analyzing the dynamics of insulin concentration in the blood is necessary for a comprehensive understanding of the effects of insulin in vivo. Insulin removal from the blood has been addressed in many studies. The results are highly variable with respect to insulin clearance and the relative contributions of hepatic and renal insulin degradation. Results: We present a dynamic mathematical model of insulin concentration in the blood and of insulin receptor activation in hepatocytes...

  15. [Anticoagulation in patients with chronic renal failure].

    Science.gov (United States)

    Niksic, L; Saudan, P; Boehlen, F

    2006-03-01

    Anticoagulation may be difficult to implement in patients suffering from chronic renal failure on account of platelet disorders and impaired clearance of some anticoagulant drugs. Although no adjustment of heparin and coumarin dosage is necessary, more frequent testing of coagulation pathways may be required when these drugs are used in patients with renal failure. Long-term use of LMWH should be implemented cautiously with regular testing of anti-factor Xa activity and a half-dose may be advocated in patients with a creatinine clearance heparin-induced thrombocytopenia with regular monitoring of coagulation tests. PMID:16562602

  16. Measuring biomarkers of acute kidney injury during renal replacement therapy: wisdom or folly?

    Science.gov (United States)

    Ostermann, Marlies; Forni, Lui G

    2014-06-19

    Early data are now appearing relating to the measurement of biomarkers of acute kidney injury during renal replacement therapy. These data go some way in describing the clearance of these molecules during renal support. Understanding the potential clearance, or otherwise, of these proteins may lead to directing our therapies in the future particularly with regard to cessation of renal support. We describe a recent study which has provided data that may aid in addressing this issue.

  17. More Power to OATP1B1: An Evaluation of Sample Size in Pharmacogenetic Studies Using a Rosuvastatin PBPK Model for Intestinal, Hepatic, and Renal Transporter-Mediated Clearances.

    Science.gov (United States)

    Emami Riedmaier, Ariane; Burt, Howard; Abduljalil, Khaled; Neuhoff, Sibylle

    2016-07-01

    Rosuvastatin is a substrate of choice in clinical studies of organic anion-transporting polypeptide (OATP)1B1- and OATP1B3-associated drug interactions; thus, understanding the effect of OATP1B1 polymorphisms on the pharmacokinetics of rosuvastatin is crucial. Here, physiologically based pharmacokinetic (PBPK) modeling was coupled with a power calculation algorithm to evaluate the influence of sample size on the ability to detect an effect (80% power) of OATP1B1 phenotype on pharmacokinetics of rosuvastatin. Intestinal, hepatic, and renal transporters were mechanistically incorporated into a rosuvastatin PBPK model using permeability-limited models for intestine, liver, and kidney, respectively, nested within a full PBPK model. Simulated plasma rosuvastatin concentrations in healthy volunteers were in agreement with previously reported clinical data. Power calculations were used to determine the influence of sample size on study power while accounting for OATP1B1 haplotype frequency and abundance in addition to its correlation with OATP1B3 abundance. It was determined that 10 poor-transporter and 45 intermediate-transporter individuals are required to achieve 80% power to discriminate the AUC0-48h of rosuvastatin from that of the extensive-transporter phenotype. This number was reduced to 7 poor-transporter and 40 intermediate-transporter individuals when the reported correlation between OATP1B1 and 1B3 abundance was taken into account. The current study represents the first example in which PBPK modeling in conjunction with power analysis has been used to investigate sample size in clinical studies of OATP1B1 polymorphisms. This approach highlights the influence of interindividual variability and correlation of transporter abundance on study power and should allow more informed decision making in pharmacogenomic study design. PMID:27385171

  18. Renal calculus disease.

    Science.gov (United States)

    Schulsinger, D A; Sosa, R E

    1998-03-01

    We have seen an explosion in technical innovations for the management of urolithiasis. Today, the endourologist possesses an assortment of minimally invasive tools to treat renal stones. Most patients receive fast, safe and effective treatment in the outpatient setting. Despite the many technical advances, however, anatomical malformations and complex stones still provide significant challenges in diagnosis, access to a targeted stone, fragmentation, and clearance of the resulting fragments. This review examines a variety of urinary stone presentations and treatment strategies for cost-effective management.

  19. Hypogonadism and renal failure: An update.

    Science.gov (United States)

    Thirumavalavan, Nannan; Wilken, Nathan A; Ramasamy, Ranjith

    2015-01-01

    The prevalence of both hypogonadism and renal failure is increasing. Hypogonadism in men with renal failure carries with it significant morbidity, including anemia and premature cardiovascular disease. It remains unclear whether testosterone therapy can affect the morbidity and mortality associated with renal failure. As such, in this review, we sought to evaluate the current literature addressing hypogonadism and testosterone replacement, specifically in men with renal failure. The articles chosen for this review were selected by performing a broad search using Pubmed, Embase and Scopus including the terms hypogonadism and renal failure from 1990 to the present. This review is based on both primary sources as well as review articles. Hypogonadism in renal failure has a multifactorial etiology, including co-morbid conditions such as diabetes, hypertension, old age and obesity. Renal failure can lead to decreased luteinizing hormone production and decreased prolactin clearance that could impair testosterone production. Given the increasing prevalence of hypogonadism and the potential morbidity associated with hypogonadism in men with renal failure, careful evaluation of serum testosterone would be valuable. Testosterone replacement therapy should be considered in men with symptomatic hypogonadism and renal failure, and may ameliorate some of the morbidity associated with renal failure. Patients with all stages of renal disease are at an increased risk of hypogonadism that could be associated with significant morbidity. Testosterone replacement therapy may reduce some of the morbidity of renal failure, although it carries risk.

  20. Renal dysfunction in patients with thalassaemia

    OpenAIRE

    Quinn, Charles T.; Johnson, Valerie L.; Kim, Hae-Young; Trachtenberg, Felicia; Vogiatzi, Maria G; Kwiatkowski, Janet L.; Neufeld, Ellis J.; Fung, Ellen; Oliveri, Nancy; Kirby, Melanie; Giardina, Patricia J.

    2011-01-01

    Little is known about the effects of thalassaemia on the kidney. Characterization of underlying renal function abnormalities in thalassaemia is timely because the newer iron chelator, deferasirox, can be nephrotoxic. We aimed to determine the prevalence and correlates of renal abnormalities in thalassaemia patients, treated before deferasirox was widely available, using 24-h collections of urine. We calculated creatinine clearance and urine calcium-to-creatinine ratio and measured urinary β2-...

  1. Recombinant human erythropoietin in humans down-regulates proximal renal tubular reabsorption and causes a fall in glomerular filtration rate

    DEFF Research Database (Denmark)

    Olsen, Niels Vidiendal; Aachmann-Andersen, Niels Jacob; Oturai, Peter;

    2010-01-01

    HuEPO for 28 days in doses raising the hematocrit to 48.3 (4.1) %. Renal clearance studies with urine collections (N = 8) were done at baseline and at days 4, 11, 29, and 42. Glomerular filtration rate (GFR) was measured by (51)Cr-EDTA. Renal clearance of lithium (C(Li)) was used as an index of proximal...

  2. The rebirth of interest in renal tubular function.

    Science.gov (United States)

    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.

  3. The rebirth of interest in renal tubular function.

    Science.gov (United States)

    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

  4. The kidneys play an important role in the clearance of rFVIIa in rats

    DEFF Research Database (Denmark)

    Vestergaard, Bill; Appa, Rupa S.; Lykkesfeldt, Jens;

    2014-01-01

    INTRODUCTION: Previous distribution and histological studies have indicated that the kidneys and renal proximal tubular cells play a role in clearance of rFVIIa. However, the relative importance of the kidneys in clearance of rFVIIa has not previously been addressed. The objective of the present...... study was to evaluate the importance of the kidneys in the clearance process of rFVIIa after iv administration to rats using a nephrectomy model. MATERIALS AND METHODS: A nephrectomized rat model was established and validated using inulin, a compound primarily cleared by the kidneys, as a test substance...

  5. Radionuclide evaluation of renal artery dilatation

    Energy Technology Data Exchange (ETDEWEB)

    Born, M.L.; Gerlock, A.J. Jr.; Goncharenko, V.; Hollifield, J.W.; MacDonell, R.C. Jr.

    1981-01-01

    Radionuclide studies were used in three patients to evaluate renal perfusion and function within 24 hours following transluminal dilatation. In one patient, technetium-99 m pertechnetate showed good renal perfusion one and 12 hours after a post-dilatation arteriogram had shown a renal artery intimal defect. Improved clearance of iodine-131 ortho-iodohippurate from the blood demonstrated an increase in renal function 18 hours following dilatation of a stenosis at a renal allograft anastomosis in the second patient, while technetium-99 m-labeled DTPA showed an improved total glomerular filtration rate 24 hours after dilatation of a saphenous vein bypass graft in the third patient. It was concluded that renal radionuclide studies are of benefit in evaluating patients in the immediate post-dilatation period.

  6. PGI2 synthesis and excretion in dog kidney: evidence for renal PG compartmentalization

    Energy Technology Data Exchange (ETDEWEB)

    Boyd, R.M.; Nasjletti, A.; Heerdt, P.M.; Baer, P.G.

    1986-01-01

    To assess the concept of compartmentalization of renal prostaglandins (PG), we compared entry of PGE2 and the PGI2 metabolite 6-keto-PGF1 alpha into the renal vascular and tubular compartments, in sodium pentobarbital-anesthetized dogs. Renal arterial 6-keto-PGF1 alpha infusion increased both renal venous and urinary 6-keto-PGF1 alpha outflow. In contrast, renal arterial infusion of arachidonic acid (AA) or bradykinin (BK) increased renal venous 6-keto-PGF1 alpha outflow but had no effect on its urinary outflow. Both urinary and renal venous PGE2 outflows increased during AA or BK infusion. Ureteral stopped-flow studies revealed no postglomerular 6-keto-PGF1 alpha entry into tubular fluid. During renal arterial infusion of (3H)PGI2 and inulin, first-pass 3H clearance was 40% of inulin clearance; 35% of urinary 3H was 6-keto-PGF1 alpha, and two other urinary metabolites were found. During renal arterial infusion of (3H)6-keto-PGF1 alpha and inulin, first-pass 3H clearance was 150% of inulin clearance; 75% of urinary 3H was 6-keto-PGF1 alpha, and only one other metabolite was found. We conclude that in the dog PGE2 synthesized in the kidney enters directly into both the renal vascular and tubular compartments, but 6-keto-PGF1 alpha of renal origin enters directly into only the renal vascular compartment.

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

    DEFF Research Database (Denmark)

    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...

  8. Clinical application of plasma clearance of iohexol on feline patients.

    Science.gov (United States)

    Miyamoto, K

    2001-09-01

    Glomerular filtration rate (GFR) was estimated by plasma clearance of iohexol (PCio) in 52 conscious cats presented for a variety of reasons to Angel Animal Hospital over a 2-year period. Cats were divided into four groups according to their clinical conditions and reasons for measuring PCio. The median PCio (ml/min/kg) was 3.68 in normal cats (NM), 2.39 in cats with suspected renal disease (SP), 1.35 in cats referred to confirm renal dysfunction (RD), and 0.84 in cats with apparent clinical signs of renal failure (RF). There was a significant difference between the results for each group. The respective medians of blood urea nitrogen (BUN) and plasma creatinine concentration (Pcr) (mg/dl) were 15 and 1.40 in NM cats, 21 and 1.71 in SP cats, 30 and 2.20 in RD cats, and 48 and 3.30 in RF cats. The reference values of BUN and Pcr were 21 +/- 7 mg/dl and 1.5 +/- 0.4 mg/dl (mean +/- SD). Diminished renal function could not be detected in SP cats by either BUN or Pcr, while a marked decrease of GFR was demonstrated before BUN and Pcr increased, indicating the insensitivity of BUN and Pcr in detecting renal dysfunction in cats. PCio can be performed non-invasively in conscious cats, which improves the veterinarian's ability to detect early stages of chronic renal disease. PMID:11876631

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

    DEFF Research Database (Denmark)

    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

  10. Factors regulating the renal circulation in spontaneously hypertensive rats

    OpenAIRE

    Ahmad F. Ahmeda; Mohammed Alzoghaibi

    2016-01-01

    Hypertension is one of the leading causes of health morbidity and mortality which are linked to many life threatening diseases such as stroke heart problems and renal dysfunction. The integrity of renal microcirculation is crucial to maintaining the clearance and the excretory function in the normotensive and hypertensive conditions. Furthermore, any alteration in the renal function is involved in the pathophysiology of hypertension. The aim of this review is to provide a brief discussi...

  11. Renal perfusion scintiscan

    Science.gov (United States)

    Renal perfusion scintigraphy; Radionuclide renal perfusion scan; Perfusion scintiscan - renal; Scintiscan - renal perfusion ... supply the kidneys. This is a condition called renal artery stenosis. Significant renal artery stenosis may be ...

  12. Specificity of increased amylase to creatinine clearance ratio in acute pancreatitis.

    Science.gov (United States)

    Lankisch, P G; Koop, H; Otto, J; Oberdieck, U; Winckler, K; Wolfrum, D I

    1977-01-01

    The amylase to creatinine clearance ratio was found to be normal in 11 of 33 patients with acute pancreatitis. The ratio was elevated in 10 of 19 patients with renal insufficiency. Thus, it does not seem to be a specific index in the diagnosis of acute pancreatitis.

  13. Renal transepithelial transport of nucleosides.

    Science.gov (United States)

    Nelson, J A; Vidale, E; Enigbokan, M

    1988-01-01

    Previous work from this and other laboratories has suggested that the mammalian kidney has unique mechanisms for handling purine nucleosides. For example, in humans and in mice, adenosine undergoes net renal reabsorption whereas deoxyadenosine is secreted [Kuttesch and Nelson: Cancer Chemother. Pharmacol. 8, 221 (1982)]. The relationships between these renal transport systems and classical renal organic cation and anion, carbohydrate, and cell membrane nucleoside transport carriers are not established. To investigate possible relationships between such carriers, we have tested effects of selected classical transport inhibitors on the renal clearances of adenosine, deoxyadenosine, 5'-deoxy-5-fluorouridine (5'-dFUR), and 5-fluorouracil in mice. The secretion of deoxyadenosine and 5'-dFUR, but not the reabsorption of adenosine or 5-fluorouracil, was prevented by the classical nucleoside transport inhibitors, dipyridamole and nitrobenzylthioinosine. Cimetidine, an inhibitor of the organic cation secretory system, also inhibited the secretion of 5'-dFUR, although it did not inhibit deoxyadenosine secretion in earlier studies [Nelson et al.: Biochem. Pharmacol. 32, 2323 (1983)]. The specific inhibitor of glucose renal reabsorption, phloridzin, failed to inhibit the reabsorption of adenosine or the secretion of deoxyadenosine. Failure of the nucleoside transport inhibitors and phloridzin to prevent adenosine reabsorption suggests that adenosine reabsorption may occur via a unique process. On the other hand, inhibition of the net secretion of deoxyadenosine and 5'-dFUR by dipyridamole and nitrobenzylthioinosine implies a role for the carrier that is sensitive to these compounds in the renal secretion (active transport) of these nucleosides.

  14. [Amylase-creatinine clearance ratios in burned patients (author's transl)].

    Science.gov (United States)

    Minaire, Y; Marichy, J; Forichon, J; Motin, J

    1978-09-01

    The amylase/creatinine clearance ratio (ACCR) has been examined every 3 days, in 34 burned patients during the 20 days following the accident. This ratio was often abnormal since it was found increased at least on one occasion, in 75% of these patients, to be compared with 23 and 13% for amylase in serum and urine respectively. In another group of 9 burned patients, the ACCR was monitored for time-period between 10 to 52 days. It was observed that a high frequency in increased ACCR was associated with a fatal outcome. Finally simultaneous measurements of ACCR and of the beta2 microglobulin/creatinine clearance ratio (MCCR) showed that increased ACCR were statistically associated with increased MCCR suggesting a decreased renal tubular reabsorption of low molecular weight proteins in these burned patients.

  15. [Amylase-creatinine clearance ratios in burned patients (author's transl)].

    Science.gov (United States)

    Minaire, Y; Marichy, J; Forichon, J; Motin, J

    1978-09-01

    The amylase/creatinine clearance ratio (ACCR) has been examined every 3 days, in 34 burned patients during the 20 days following the accident. This ratio was often abnormal since it was found increased at least on one occasion, in 75% of these patients, to be compared with 23 and 13% for amylase in serum and urine respectively. In another group of 9 burned patients, the ACCR was monitored for time-period between 10 to 52 days. It was observed that a high frequency in increased ACCR was associated with a fatal outcome. Finally simultaneous measurements of ACCR and of the beta2 microglobulin/creatinine clearance ratio (MCCR) showed that increased ACCR were statistically associated with increased MCCR suggesting a decreased renal tubular reabsorption of low molecular weight proteins in these burned patients. PMID:360162

  16. Measurement of serum cystatin C, creatinine clearance and urea micro-albumin as renal function evaluation indicators in cancer patients during chemotherapy with platinum%血清胱抑素C、内生肌酐清除率及尿微量白蛋白在恶性肿瘤含顺铂化疗患者肾功能评价中的地位

    Institute of Scientific and Technical Information of China (English)

    Xun Cai; Peng Xue; Meizhen Gu; Jiong Hu; Hongli Gu; Haiyan Yang; Liwei Wang

    2011-01-01

    Objective: Chemotherapy drugs such as platinum may cause damage to the renal function, creatinine clearance (Ccr), as a "golden standard" indicator in clinical evaluation of renal function, was limited in application due to complicated detection steps. By detecting the expression of serum Cystatin C (Cys C), Ccr and urinary micro-albumin (UMA), this study was designed to analyze and discuss their roles and status in renal function evaluation for cancer patients before and after chemotherapy with platinum. Methods: We retrospectively reviewed 110 patients who receiving platinum-containing protocols or non-platinum-containing ones, and got the expression of Cys C, Ccr (was calculated by Cockcroft-Gault equation) and UMA, then analyzed whether there were differences for Cys C,Ccr and UMA in those patients; for patients with mildly impaired renal function (Ccr between 50–75 mL/min), whether there were differences for Cys C and UMA before and after chemotherapy with platinum. Results: There was statistical significance for Ccr, Cys C and UMA in patients who receiving platinum-containing protocols (85.01 ± 28.40) vs (76.79 ± 26.63) mL/min, (1.49 ± 0.50) vs (1.80 ± 0.84) mg/L and (14.30 ± 9.15) vs (16.90 ± 10.95) mg/L, P = 0.00, 0.00 and 0.01), and no statistical significance for those receiving non-platinum-containing ones (89.45 ± 29.69) vs (86.78 ± 27.96) mL/min, (1.51 ± 0.78) vs (1.63 ± 0.73)mg/L and (17.31 ± 10.46) vs (16.59 ± 8.33) mg/L, P = 0.45, 0.07 and 0.57); and there were also significant differences for Cys C for patients with mildly impaired renal function before and after chemotherapy (1.68 ± 0.55) vs (2.04 ± 0.68) mg/L, P = 0.03), while no statistical significance for UMA for the same ones (21.11 ± 10.06) vs (21.22 ± 8.81) mg/L, P = 0.93). There were statistical significance both for Cys C and UMA before and after chemotherapy in platinum-containing group, but the AUC for Ccr and Cys C is greater than that for UMA (P < 0.02). Conclusion

  17. Measuring residual renal function in dialysis patients: can we dispense with 24-hour urine collections?

    Science.gov (United States)

    Davenport, Andrew

    2016-05-01

    Residual renal function is associated with improved survival and quality of life for dialysis patients. Whereas residual renal function is monitored in peritoneal dialysis patients, many hemodialysis centers simply concentrate on achieving dialyzer urea clearance targets. Accurately quantifying residual renal function from urine collections is arduous. Thus, there is a clinical need to develop alternative methods of assessing residual renal function based on serum testing, especially for patients receiving less than thrice weekly dialysis.

  18. Pharmacokinetics, metabolism and renal clearance of flumequine in veal calves.

    Science.gov (United States)

    Mevius, D J; Breukink, H J; Guelen, P J; Jansen, T; De Grève, B

    1990-06-01

    The pharmacokinetics of flumequine was studied in 1-, 5- and 18-week-old veal calves. A two-compartment model was used to fit the plasma concentration-time curve of flumequine after the intravenous injection of 10 mg/kg of a 10% solution. The elimination half-life (t1/2 beta) of the drug ranged from 6 to 7 h. The Vd beta and ClB of 1-week-old calves (1.07 l/kg, 1.78 ml/min/kg) were significantly lower than those of 5-week-old (1.89 l/kg, 3.23 ml/min/kg) and 18-week-old calves (1.57 l/kg, 3.10 ml/min/kg). After the oral administration of 10 mg/kg of a 2% flumequine formulation mixed with milk replacer, the Cmax was highest in 1-week-old (9.27 micrograms/ml) and lowest in 18-week-old calves (4.47 micrograms/ml). The absorption was rapid (Tmax of approximately 3 h) and complete. When flumequine itself and a formulation containing 2% flumequine and 20 X 10(6) iu of colistin sulphate were mixed with milk replacer and administered at the same dose rate, absorption was incomplete and Cmax was lower. The main urinary metabolite of flumequine was the glucuronide conjugate (approximately 40% recovery within 48 h of intravenous injection) and the second most important metabolite was 7-hydroxy-flumequine (approximately 3% recovery within 12 h of intravenous injection). Only 3.2-6.5% was excreted in the urine unchanged. After oral administration a 'first-pass' effect was observed, with a significant increase in the excretion of conjugated drug. For 1-week-old calves it is recommended that the 2% formulation should be administered at a dose rate of 8 mg/kg every 24 h or 4 mg/kg every 12 h; for calves over 6 weeks old, the dose should be increased to 15 mg/kg every 24 h or 7.5 mg/kg every 12 h. The formulation containing colistin sulphate should be administered to 1-week-old calves at a flumequine dose of 12 mg/kg every 24 h or 6 mg/kg every 12 h. PMID:2384907

  19. Comparison of glomerular filtration rates by dynamic renal scintigraphy and dual-plasma sample clearance method in diabetic nephropathy%肾动态显像法与双血浆法测定糖尿病肾病患者GFR的比较

    Institute of Scientific and Technical Information of China (English)

    解朋; 黄建敏; 潘莉萍; 刘晓梅; 魏玲格; 高建青

    2010-01-01

    目的 以双血浆法测得的肾小球滤过率(GFR)为参考标准,评价99Tcm-DTPA肾动态显像法测得的糖尿病肾病患者GFR的可靠性及准确性.方法 选择46例确诊为糖尿病肾病的患者,分别采用肾动态显像法和双血浆法测定其GFR(GFR肾动态法和GFR双血浆法).用配对t检验分析经体表面积标准化(1.73 m-2)的GFR肾动态法与GFR双血浆法间的差异有无统计学意义,并行相关性分析.结果 46例糖尿病肾病患者的GFR肾动态法范围为11.87~107.00 ml·min-1,均值为(51.08±26.78)ml·min-1;GFR双血浆法范围为4.17~118.56ml·min-1,均值为(44.06±29.43)ml·sin-1;两者间差异有统计学意义(t=4.209,P=0.000),前者略高于后者,且两者呈显著正相关(r=0.923,P=0.000),直线回归方程为GFR双血浆法=1.015×GFR肾动态法-7.773(F=254.656,P=0.000).结论 GFR肾动志法与GFR双血浆法的差异有统计学意义,对于糖尿病肾病患者尚不能用GFR肾动态法代替GFR双血浆法;但肾动态显像法能够较准确评价糖尿病肾病患者的肾滤过功能.%Objective To evaluate the accuracy of renal scintigraphy for the estimation of glomerular filtration rates (dGFR) in patients with diabetic nephropathy as compared to the conventional dual-plasma sample clearance method (pscGFR). Methods Forty-six patients with diabetic nephropathy underwent both dynamic renal scintigraphy and dual-plasma sample measurement after 99Tcm-DTPA injection. Paired student t-test and correlation analysis were performed to compare dGFR and pscGFR (normalized to body surface area,1.73 m-2). Results The mean dGFR was higher than mean pscGFR ((51.08±26.78)ml·min-1vs (44.06±29.43)ml·min-1,t=4.209,P=0.000). The dGFR correlated with pscGFR ( r=0.923,P=0.000) linearly (regression equation:pscGFR=1.015×dGFR-7.773,F=254. 656,P=0.000).Conclusions dGFR correlated well with pscGFR. Although it could not absolutely replace the latter in patients with diabetic nephropathy,dGFR could

  20. Assessment of glomerular filtration rate and effective renal plasma flow in cystic fibrosis

    International Nuclear Information System (INIS)

    A study was conducted to examine renal function in 10 healthy control subjects and eight patients with cystic fibrosis in stable condition. Sequential bolus injections of /sup 99m/Tc-DTPA and 125I-OIH were administered to assess glomerular filtration rate and effective renal plasma flow, respectively. Blood was subsequently collected for 3 hours, and urine for 24 hours. Renal clearances of both radioisotope markers were virtually identical in patients and controls. Inasmuch as neither glomerular filtration rate nor effective renal plasma flow was enhanced in patients with cystic fibrosis, increased clearance of drugs in these patients is unlikely to be the result of enhanced glomerular filtration or tubular secretion

  1. Digitalis pharmacokinetics and therapy with respect to impaired renal function.

    Science.gov (United States)

    Kramer, P

    1977-01-01

    The various cardiac glycosides differ significantly in their retention as a result of renal failure. In the case of digoxin, digitoxin, and strophanthin the retention is directly related to the normal renal clearance of these cardiac glycosides: Strophanthin has the highest clearance and the most marked prolongation of pharmacological action in renal failure, whereas digitoxin shows the lowest renal clearance and even in uremic patients a total elimination comparable to normal subjects as a result of increased hepatic clearance; digoxin takes an intermediate position. The quantity of a cardiac glycoside and its metabolites excreted by the kidneys depends, besides the renal clearance, on the plasma concentration which increases considerably during the first days after onset of treatment. From the daily dose approximately 90% of strophanthin, 70% of digoxin, 50% of digitoxin plus metabolites are excreted by normal kidneys under steady-state conditions. The efficiency of hemodialysis in the elimination of cardiac glycosides is low (3-5%) if estimated in relation to a single dose injected before dialysis and high (30-50%) if estimated in relation to the excretory capacity of normal kidneys during a period corresponding to the duration of a dialysis. During hemodialysis the plasma concentration of digoxin decreases as rapidly as in patients with normal renal function. Beside the efficiency of dialysis this finding may be explained by the decrease in the apparent volume of distribution of cardiac glycosides in patients with advanced renal failure; a reduced tissue protein binding seems likely to be the main reason for these changes in chronic renal insufficiency. A reduced volume of distribution and a reduced myocardial sensitivity are the main reasons for a very low predictability of the necessary individual maintenance dose of cardiac glycosides from the creatinine clearance. In patients with advanced renal insufficiency the tolerance to cardiac glycosides is reduced

  2. Renal angiomyolipoma

    DEFF Research Database (Denmark)

    Holm-Nielsen, P; Sørensen, Flemming Brandt

    1988-01-01

    Renal angiomyolipoma is a rare lesion composed of smooth muscle cells, adipose tissue and abnormal vessels. It is currently classified as a benign, non-epithelial renal tumor. It has a high incidence in patients suffering from tuberous sclerosis but is more frequently found as an isolated renal...... features. However, a smaller number of smooth muscle cells also contained lipid, thus simulating an intermediate cell stage between adipose- and smooth muscle cells. The abnormal thickening of the subendothelial spaces contained collagen fibrils in a homogeneous matrix, fibroblast-like cells and non......-specific vesicular structures. These findings suggest a secondary vascular damage, i.e. the thickened vessels may not be a primary, integral part of renal angiomyolipoma. Evidence of a common precursor cell of renal angiomyolipoma was not disclosed. It is concluded that renal angiomyolipoma is a hamartoma composed...

  3. Changes in renal tri-iodothyronine and thyroxine handling during fasting

    NARCIS (Netherlands)

    E.J. Rolleman; G. Hennemann; H. van Toor (Hans); C.H.H. Schoenmakers (Christian); E.P. Krenning (Eric); M. de Jong (Marion)

    2000-01-01

    textabstractOBJECTIVE: Liver handling of thyroid hormones (TH) has been known to alter significantly during fasting. This study investigates whether renal handling of TH is also changed during fasting. METHODS: We measured urinary excretion rates and clearances of free

  4. Renal liposarcoma

    Directory of Open Access Journals (Sweden)

    Diogo A.L. Bader

    2004-06-01

    Full Text Available INTRODUCTION: Liposarcoma is a malignant mesenchymal tumor frequently located in retroperitoneum, and rarely presenting an isolated lesion in kidney. CASE REPORT: Female, Caucasian, 49-year old patient, with family history of renal polycystic disease, was selected for organ donation. During preoperative examinations a renal pleomorphic liposarcoma was detected. She was treated with radical nephrectomy and remains asymptomatic, without evidences of recurrence in control ecographic examinations after a 4-year follow-up. COMMENTS: Renal liposarcoma is a rare tumor. We report one case incidentally diagnosed during a routine pre-transplantation assessment in renal donor.

  5. RENAL CRYOABLATION

    Directory of Open Access Journals (Sweden)

    A. V. Govorov

    2012-01-01

    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.

  6. Lactate clearance in cardiorespiratory emergency

    Directory of Open Access Journals (Sweden)

    Serena Greco

    2007-08-01

    Full Text Available Early goal directed therapy has been found to improve prognosis in septic patients, if the therapeutic goal is achieved within the first six hours. The aim of our study is to demonstrate that in patients with acute cardiorespiratory failure, rapid (within 2 hours lactate clearance can help define patients’ prognosis. 67 consecutive patients, admitted to our 16-bed Emergency Medicine ward for acute cardiorespiratory failure (age 75,9 ± 9,8 (APACHE II score 19,0 ± 4,1, were included in the study. Blood lactate concentration was read at admission and after 2, 6 and 24 hours. We evaluated mortality at seven days and the use of orotracheal intubation (patients with negative outcome vs. discharge or transfer to a non-emergency ward with subsequent discharge (patients with negative outcome. Lactate concentration at admission was 4,6 ± 2,5 mmol/l; lactate clearance (% at 2 hours was 40,4 ± 32,1 in patients with a positive outcome and –8,3 ± 5,0 in patients with a negative outcome (p < 0,05. Lactate clearance at 2 hours < 25% is correlated to a negative outcome with an 84,2% sensitivity and a 79,2% specificity. The positive predictive value was 61,5% and the negative predictive value was 92,2%. Systematic lactate clearance monitoring can be used in cases of acute cardiorespiratory insufficiency to identify patients with a high risk of negative outcome. In our study, low clearance at two hours was associated with an increase in mortality and/or the need for orotracheal intubation. Conversely, a clearance at two hours of > 25% in most cases confirms the therapeutic strategy undertaken. Serial evaluation of blood lactate concentration may therefore be useful in guiding treatment strategies.

  7. Overall renal and tubular function during infusion of amino acids in normal man

    DEFF Research Database (Denmark)

    Olsen, Niels Vidiendal; Hansen, J M; Ladefoged, S D;

    1990-01-01

    infusion of amino acids was studied in 12 normal volunteers. 3. Clearance of sodium (CNa) was unchanged. Effective renal plasma flow increased slightly, but significantly, by 9% (P less than 0.05). GFR was increased by 13% (P less than 0.001). Clearance of lithium (CLi) (used as an index of proximal...

  8. Renal fallure

    Institute of Scientific and Technical Information of China (English)

    1992-01-01

    920705 Endothelin and acute renal failure:study on their relationship and possiblemechanisms. LIN Shanyan(林善锬), et al.Renal Res Lab, Huashan Hosp, Shanghai MedUniv, Shanghai, 200040. Natl Med J China 1992;72(4): 201-205. In order to investigate the role of endothelin

  9. Noninvasive clearance of airway secretions.

    Science.gov (United States)

    Hardy, K A; Anderson, B D

    1996-06-01

    Airway clearance techniques are indicated for specific diseases that have known clearance abnormalities (Table 2). Murray and others have commented that such techniques are required only for patients with a daily sputum production of greater than 30 mL. The authors have observed that patients with diseases known to cause clearance abnormalities can have sputum clearance with some techniques, such as positive expiratory pressure, autogenic drainage, and active cycle of breathing techniques, when PDPV has not been effective. Hasani et al has shown that use of the forced exhalatory technique in patients with nonproductive cough still resulted in movement of secretions proximally from all regions of the lung in patients with airway obstruction. It is therefore reasonable to consider airway clearance techniques for any patient who has a disease known to alter mucous clearance, including CF, dyskinetic cilia syndromes, and bronchiectasis from any cause. Patients with atelectasis from mucous plugs and hypersecretory states, such as asthma and chronic bronchitis, patients with pain secondary to surgical procedures, and patients with neuromuscular disease, weak cough, and abnormal patency of the airway may also benefit from the application of airway clearance techniques. Infants and children up to 3 years of age with airway clearance problems need to be treated with PDPV. Manual percussion with hands alone or a flexible face mask or cup and small mechanical vibrator/percussors, such as the ultrasonic devices, can be used. The intrapulmonary percussive ventilator shows growing promise in this area. The high-frequency oscillator is not supplied with vests of appropriate sizes for tiny babies and has not been studied in this group. Young patients with neuromuscular disease may require assisted ventilation and airway oscillations can be applied. CPAP alone has been shown to improve achievable flow rates that will increase air-liquid interactions for patients with these diseases

  10. The use of lithium clearance measurements as an estimate of glomerulo-tubular function.

    Science.gov (United States)

    Whiting, P H

    1999-01-01

    Lithium clearance measurements are based on the observation that lithium undergoes isoosmotic reabsorption in the proximal renal tubule to the same extent as salt and water, but undergoes neither reabsorption nor secretion elsewhere in the nephron. Consequently, lithium clearance values estimate the delivery of isoosmotic fluid to the loop of Henle and hence provide an assessment of proximal tubular reabsorption of isoosmotic fluid. If sodium clearance and urinary flow rate are also measured, then this allows the derivation of a number of parameters relating to both the absolute and relative renal handling of isoosmotic fluid in the proximal and distal regions of the kidney. Consequently, lithium clearance techniques can be used in both experimental and clinical studies to evaluate glomerulo-tubular function and provide information regarding the handling of sodium and water by the proximal and distal nephron in both health and disease. The use of lithium clearance measurements in the assessment of glomerulo-tubular function in patients treated with rIL2 for colorectal cancer is described and its application to both drug-induced toxicity and other disease states discussed.

  11. Comparative study of conventional PAH and inulin clearance and slope clearance of 131I-o-hippuric acid and 51Cr-EDTA

    International Nuclear Information System (INIS)

    ''Classic'' PAH and inulin clearance were determined in 81 patients with renal anomalies or renal diseases of different genesis and severity. In addition, radioisotope nephrography was carried out after administration of I-131-o-hippuric acid, followed by administration of Cr-51-EDTA. The activity decrease was recorded by a sensor located over the patient's right shoulder; the activities of a serum sample and of the urine excreted after 21 or 31 min were measured, and the findings were compared with those of the classic method. The clearance data calculated on the basis of the soulder measurements were hardly compatible with those of the conventional method in the case of 131I-o-hippuric acid (r=0.54) and totally incompatible in the case of 51Cr-EDTA. This means that the method described by Oberhausen is the only accurate method available for a quantitative assessment of the renal function on the basis of measurements of the activity decrease in the body. The activity of urine excreted after 31 min (131I-hippuric acid:r=0.992, 51Cr-EDTA:r=0.79) is a sufficiently accurate parameter although it is inaccurate at PAH clearance, values > 130 ml/min and inulin clearance values > 30 ml/min. Of the many parameters of radioisotope nephrogram curves, in the case of 131I-o-hippuric acid only the parameters related to the ascent between 48 and 120 sec or to the secant ascent yield sufficient quantitative information for certain functional regions (r=0.9 resp. r=0.93). In the case of 51Cr-EDTA, semiquantitative information on the renal function can be obtained by constructing secants on the nephrogram curves (r=0.7 resp. r=0.72). Here as in the case of 131I-hippuric acid, the contribution of each kidney can be determined individually from the functional analysis of both kidneys. (orig.)

  12. [Renal elastography].

    Science.gov (United States)

    Correas, Jean-Michel; Anglicheau, Dany; Gennisson, Jean-Luc; Tanter, Mickael

    2016-04-01

    Renal elastography has become available with the development of noninvasive quantitative techniques (including shear-wave elastography), following the rapidly growing field of diagnosis and quantification of liver fibrosis, which has a demonstrated major clinical impact. Ultrasound or even magnetic resonance techniques are leaving the pure research area to reach the routine clinical use. With the increased incidence of chronic kidney disease and its specific morbidity and mortality, the noninvasive diagnosis of renal fibrosis can be of critical value. However, it is difficult to simply extend the application from one organ to the other due to a large number of anatomical and technical issues. Indeed, the kidney exhibits various features that make stiffness assessment more complex, such as the presence of various tissue types (cortex, medulla), high spatial orientation (anisotropy), local blood flow, fatty sinus with variable volume and echotexture, perirenal space with variable fatty content, and the variable depth of the organ. Furthermore, the stiffness changes of the renal parenchyma are not exclusively related to fibrosis, as renal perfusion or hydronephrosis will impact the local elasticity. Renal elastography might be able to diagnose acute or chronic obstruction, or to renal tumor or pseudotumor characterization. Today, renal elastography appears as a promising application that still requires optimization and validation, which is the contrary for liver stiffness assessment. PMID:26976058

  13. 49 CFR 192.325 - Underground clearance.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 3 2010-10-01 2010-10-01 false Underground clearance. 192.325 Section 192.325... Lines and Mains § 192.325 Underground clearance. (a) Each transmission line must be installed with at least 12 inches (305 millimeters) of clearance from any other underground structure not associated...

  14. 30 CFR 18.24 - Electrical clearances.

    Science.gov (United States)

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Electrical clearances. 18.24 Section 18.24... APPROVAL OF MINING PRODUCTS ELECTRIC MOTOR-DRIVEN MINE EQUIPMENT AND ACCESSORIES Construction and Design Requirements § 18.24 Electrical clearances. Minimum clearances between uninsulated electrical...

  15. 14 CFR 25.925 - Propeller clearance.

    Science.gov (United States)

    2010-01-01

    ... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Propeller clearance. 25.925 Section 25.925 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION AIRCRAFT AIRWORTHINESS STANDARDS: TRANSPORT CATEGORY AIRPLANES Powerplant General § 25.925 Propeller clearance. Unless smaller clearances are substantiated,...

  16. Agalsidase benefits renal histology in young patients with Fabry disease.

    Science.gov (United States)

    Tøndel, Camilla; Bostad, Leif; Larsen, Kristin Kampevold; Hirth, Asle; Vikse, Bjørn Egil; Houge, Gunnar; Svarstad, Einar

    2013-01-01

    The effect of early-onset enzyme replacement therapy on renal morphologic features in Fabry disease is largely unknown. Here, we evaluated the effect of 5 years of treatment with agalsidase alfa or agalsidase beta in 12 consecutive patients age 7-33 years (median age, 16.5 years). We performed renal biopsies at baseline and after 5 years of enzyme replacement therapy; 7 patients had additional biopsies after 1 and 3 years. After a median of 65 months, biopsy findings from all patients showed total clearance of glomerular endothelial and mesangial cell inclusions, and findings from 2 patients showed complete clearance of inclusions from epithelial cells of the distal tubule. The 4 patients who received the highest dose of agalsidase exhibited substantial clearance of podocyte inclusions, and the youngest patient had nearly complete clearance of these inclusions. Linear regression analysis showed a highly significant correlation between podocyte globotriaocylceramide clearance and cumulative agalsidase dose (r=0.804; P=0.002). Microalbuminuria normalized in five patients. In summary, long-term enzyme replacement therapy in young patients can result in complete globotriaocylceramide clearance of mesangial and glomerular endothelial cells across all dosage regimens, and clearance of podocyte inclusions is dose-dependent.

  17. Osteodistrofia renal

    OpenAIRE

    Teles, Tobias José Freitas Trindade

    2014-01-01

    A doença renal crónica é um problema de saúde mundial, com incidência e prevalência crescentes. Apesar dos avanços científicos na compreensão da patogénese e o desenvolvimento de terapêuticas mais eficazes, a osteodistrofia renal continua a ser uma complicação importante nos doentes renais crónicos. A osteodistrofia renal abrange um espectro diverso de alterações ósseas nos doentes com doença renal crónica, classificada histologicamente por lesões de elevada ou baixa taxa de remodelação ó...

  18. Renal failure

    Institute of Scientific and Technical Information of China (English)

    1993-01-01

    930150 Epidermal growth factor and its recep-tor in the renal tissue of patients with acute re-nal failure and normal persons.LIU Zhihong(刘志红),et al.Jinling Hosp,Nanjing,210002.Natl Med J China 1992;72(10):593-595.Epidermal growth factor(EGF)and its receptor(EGF-R)were identified by immunohis-tochemical method(4 layer PAP)in the renaltissue specimens obtained from 11 normal kid-neys and 17 cases of acute renal failure(ARF).The quantitative EGF and EGF-R in the tissuewere expressed as positive tubules per mm~2.The amount of EGF and EGF-R in renal tissue

  19. Renal failure

    Institute of Scientific and Technical Information of China (English)

    1995-01-01

    950351 Serum erythropoietin levels in chronic renalinsufficiency.ZHAI Depei(翟德佩),et al.DeptNephrol.General Hosp,Tianjin Med Univ,Tianjin,300000.Tianjin Med J 1995;23(1):19-21.Patients with chronic renal insufficiency(CRI) areoften associated with anemia.The deficiency of EPOproduction in the kidney is thought to be a key factorin the pathogenesis of renal anemia.Serum erythropoi-

  20. Renal liposarcoma

    OpenAIRE

    Diogo A.L. Bader; Luis A.B. Peres; Sérgio L. Bader

    2004-01-01

    INTRODUCTION: Liposarcoma is a malignant mesenchymal tumor frequently located in retroperitoneum, and rarely presenting an isolated lesion in kidney. CASE REPORT: Female, Caucasian, 49-year old patient, with family history of renal polycystic disease, was selected for organ donation. During preoperative examinations a renal pleomorphic liposarcoma was detected. She was treated with radical nephrectomy and remains asymptomatic, without evidences of recurrence in control ecographic examinations...

  1. Renal failure

    Institute of Scientific and Technical Information of China (English)

    2005-01-01

    2005234 Association between serum fetuin-A and clinical outcome in end-stage renal disease patients. WANG Kai(王开), Dept Renal Dis, Renji Hosp Shanghai, 2nd Med Univ, Shanghai 200001. Chin J Nephrol, 2005;21(2):72-75. Objective: To investigate the change of serum fetuin-A level before and after dialysis, and the association of serum fetuin-A level with clinical parameters

  2. Renal failure

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    2008463 Protective effect of recombination rat augmenter of liver regeneration on kidney in acute renal failure rats. TANG Xiaopeng(唐晓鹏), et al. Dept Nephrol, 2nd Affili Hosp Chongqing Med Univ, Chongqing 400010.Chin J Nephrol 2008;24(6):417-421. Objective To investigate the protective effects of recombination rat augmenter of liver regeneration (rrALR) on tubular cell injury and renal dysfunction

  3. Renal haemodynamics, sodium and water reabsorption during continuous intravenous infusion of recombinant interleukin-2

    DEFF Research Database (Denmark)

    Geertsen, P F; von der Maase, H; Olsen, Niels Vidiendal;

    1998-01-01

    1. Renal haemodynamics, lithium and sodium clearance were measured in 14 patients treated with recombinant interleukin-2 for metastatic renal cell carcinoma. 2. Patients were studied before and after 72 h of continuous intravenous infusion of recombinant interleukin-2 (18x10(6) i.u..24 h-1.m-2...

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

    NARCIS (Netherlands)

    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

  5. Standardization of a method to calculate absolute renal uptake of {sup 99m} Tc-DMSA in children; Padronizacao do metodo para calculo da captacao renal absoluta do {sup 99m}Tc-DMSA em criancas

    Energy Technology Data Exchange (ETDEWEB)

    Ono, Carla Rachel; Sapienza, Marcelo Tatit; Watanabe, Tomoco; Costa, Paulo Luiz Aguirre; Okamoto, Miriam Roseli Yoshie; Garcez, Alexandre Teles; Buchpiguel, Carlos Alberto [Sao Paulo Univ., SP (Brazil). Hospital das Clinicas. Servico de Medicina Nuclear]. E-mail: crachelo@usp.br; Machado, Beatriz Marcondes; Machado, Marcia Melo Campos [Paulo Univ., SP (Brazil). Faculdade de Medicina. Hospital Universitario; Liberato Junior, Waldyr de Paula

    2006-01-15

    Objective:To standardize a method and determine normal values for absolute renal uptake of 99m Tc-DMSA in children with normal creatinine clearance. Materials and methods: Twenty-two children (between 7 months and 10 years of age; mean 4.5 years) without clinical evidence of renal disease were studied using 99m Tc-DMSA scintigraphy. Eighteen had normal renal ultrasonography, micturating urethrocystography, creatinine clearance and visual interpretation of the scintigraphy with 99m Tc-DMSA. Four children were excluded, one with incomplete creatinine clearance and three due to reduction in the creatinine clearance. Absolute renal uptake of 99m Tc-DMSA (DMSA-Abs) was expressed as the fraction of the administered dose retained by each kidney six hours after administration of the radiopharmaceutical. Results: DMSA-Abs was 21.8 +- 3.2% for the right kidney and 23.1 +-3.3% for the left kidney. There was no correlation between renal uptake and the age groups studied, although there was a tendency to an increase in the creatinine clearance with age. Conclusion: Normal values of DMSA-Abs can be used as an additional parameter for the initial diagnostic evaluation and during follow-up of renal diseases, mainly when bilateral impairment of renal function is suspected or in a patient with a single functioning kidney (in which renal differential function is of limited value). (author)

  6. Indications and results of the unilateral /sup 123/I-hippurate-clearance in an ambulant urological-nephrological patients collective

    Energy Technology Data Exchange (ETDEWEB)

    Mariss, P.; Haubold, E.

    1988-02-01

    In 572 nephrological-urological ambulant patients 688 estimations of unilateral renal plasma flow were performed after application of 300 kBq/kg /sup 123/I-hippurate using a large field scintillation camera, external scintillation probe over the right shoulder and a computer system. The indications were patients with hypertension, chronic pyelonephritis, unilateral nephrocirrhosis, exclusion or approval of renal failure, furthermore diverse malformations of the urovesical system, nephrolithiasis and follow-up after urological operations. The unilateral renal clearance by /sup 123/I-hippurate represents an important diagnostic tool in urological-nephrological patients with special diseases in addition to morphological and microbiological methods.

  7. Indications and results of the unilateral 123I-hippurate-clearance in an ambulant urological-nephrological patients collective

    International Nuclear Information System (INIS)

    In 572 nephrological-urological ambulant patients 688 estimations of unilateral renal plasma flow were performed after application of 300 kBq/kg 123I-hippurate using a large field scintillation camera, external scintillation probe over the right shoulder and a computer system. The indications were patients with hypertension, chronic pyelonephritis, unilateral nephrocirrhosis, exclusion or approval of renal failure, furthermore diverse malformations of the urovesical system, nephrolithiasis and follow-up after urological operations. The unilateral renal clearance by 123I-hippurate represents an important diagnostic tool in urological-nephrological patients with special diseases in addition to morphological and microbiological methods. (orig.)

  8. Glomerular filtration rate estimated from the uptake phase of 99mTc-DTPA renography in chronic renal failure

    DEFF Research Database (Denmark)

    Petersen, L J; Petersen, J R; Talleruphuus, U;

    1999-01-01

    The purpose of the study was to compare the estimation of glomerular filtration rate (GFR) from 99mTc-DTPA renography with that estimated from the renal clearance of 51Cr-EDTA, creatinine and urea.......The purpose of the study was to compare the estimation of glomerular filtration rate (GFR) from 99mTc-DTPA renography with that estimated from the renal clearance of 51Cr-EDTA, creatinine and urea....

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

    OpenAIRE

    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...

  10. Comparison of measurements of plasma clearance of Mebrofenine and of indocyanine green; Comparaison des mesures de clairance plasmatique de la mebrofenine et du vert d`indocyanine

    Energy Technology Data Exchange (ETDEWEB)

    Maurel, G.; Coutris, G. [Service Central de Medecine Nucleaire, Hopital Saint Antoine (France); Vaubourdolle, M. [Laboratoire de Biochimie A, Hopital Saint Antoine (France); Attal, P.; Patureau, R.; Tabsoba, Th. [Service Central de Medecine Nucleaire, Hopital Saint Antoine (France); Mensch, B. [Laboratoire de Biophysique, CHU Saint Antoine (France); Askienazy, Pr.S. [Service Central de Medecine Nucleaire, Hopital Saint Antoine (France)

    1997-12-31

    The importance of clearance measurements in evaluating renal or hepatic function needs not further demonstration. The isotopic methods were proved in renal exploration but their utilization in exploration of hepato-biliary function needs to be evaluated. In this work we have compared the measurement of plasma clearance by Mebrofenine, a radiopharmaceutical of specifically hepatic elimination, with the reference method, the clearance of indocyanine green. On the basis of scintigraphic data from 23 patients who benefited by a hepato-biliary exploration by Mebrofenine-{sup 99m}Tc for pre-surgery account and surveillance, we have determined the plasma clearance of this radiopharmaceutical. The method makes use of the curve of normalized cardiac activity by a blood sampling, taken 60 minutes after injection. The measurement of the clearance of indocyanine green was effected within a delay inferior to 1 month from the moment of biliary scintigraphy. The average clearance of Mebrofenine-{sup 99m}Tc is of 553 ml/min for 1.73 m{sup 2} of corporal surface (typical interval is 374 ml/min), the value of indocyanine green is of 450 ml/min (typical interval is 229 ml/min). The two measurements of clearance are correlated (p = 0.05). In conclusion, the measurement of clearance by Mebrofenine-{sup 99m} appears to be adapted to the evaluation of hepato-biliary function

  11. Mathematical modeling and analysis of insulin clearance in vivo

    OpenAIRE

    Gilles Ernst; Koschorreck Markus

    2008-01-01

    Abstract Background Analyzing the dynamics of insulin concentration in the blood is necessary for a comprehensive understanding of the effects of insulin in vivo. Insulin removal from the blood has been addressed in many studies. The results are highly variable with respect to insulin clearance and the relative contributions of hepatic and renal insulin degradation. Results We present a dynamic mathematical model of insulin concentration in the blood and of insulin receptor activation in hepa...

  12. [Renal disease].

    Science.gov (United States)

    Espinosa-Cuevas, María de Los Ángeles

    2016-09-01

    Chronic renal failure in its various stages, requires certain nutritional restrictions associated with the accumulation of minerals and waste products that cannot be easily eliminated by the kidneys. Some of these restrictions modify the intake of proteins, sodium, and phosphorus. Milk and dairy products are sources of these nutrients. This article aims to inform the reader about the benefits including milk and dairy products relying on a scientific and critical view according to the clinical conditions and the stage of renal disease in which the patient is. PMID:27603894

  13. Clinical Study on Treatment of Chronic Renal Failure with Shenshuailing

    Institute of Scientific and Technical Information of China (English)

    鞠建伟; 郭亚玲; 梁延平; 孙世宁; 杨建华; 杨素云

    2001-01-01

    The therapeutic effects of Shenshuailing Kou Fu Ye (SKFY肾衰灵口服液, the Oral Liquid for Renal Failure) and Shenshuailing Guan Chang Ye (SGCY肾衰灵灌肠液, the Enema for Renal Failure) were evaluated in treatment of chronic renal failure, with coateg aldehyde oxystarch as the controls. The changes in the clinical symptoms, serum creatinine, blood urea nitrogen and creatinine clearance rate were observed. The total effective rate in the former was 90.46%, and the latter 60.43%.

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

    DEFF Research Database (Denmark)

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

    2011-01-01

    if treatments that lower tissue AGE burden in patients and mice would improve obesity-related renal dysfunction. Overweight and obese individuals (body mass index (BMI) 26-39¿kg/m(2)) were recruited to a randomized, crossover clinical trial involving 2 weeks each on a low- and a high-AGE-containing diet. Renal......-lowering pharmaceutical, alagebrium, and mice in which the receptor for AGE (RAGE) was deleted. Obesity, resulting from a diet high in both fat and AGE, caused renal impairment; however, treatment of the RAGE knockout mice with alagebrium improved urinary albumin excretion, creatinine clearance, the inflammatory profile...

  15. Pharmacokinetics: metabolism and renal excretion of quinolones in man.

    Science.gov (United States)

    Vree, T B; Wijnands, W J; Guelen, P J; Baars, A M; Hekster, Y A

    1986-02-21

    The quinolones are relatively poorly absorbed from the gastrointestinal tract. The elimination proceeds mainly by renal excretion. The half-life of elimination depends on the molecular structure and varies between 2 and 10 h. Impaired kidney function is expected to increase the half-life of elimination, though this effect is not always observed. Since the 4-oxo-metabolites show a higher renal clearance than the parent drug, renal impairment will result in a cumulation of the metabolites in the body. PMID:3960691

  16. Pharmacokinetics of the Long‐Acting Basal Insulin LY2605541 in Subjects With Varying Degrees of Renal Function

    Science.gov (United States)

    Linnebjerg, Helle; Choi, Siak Leng; Lam, Eric Chen Quin; Mace, Kenneth F.; Hodgson, Teri S.; Sinha, Vikram P.

    2016-01-01

    Abstract The pharmacokinetics of LY2605541 (basal insulin peglispro), a novel long‐acting basal insulin analogue, was evaluated in 5 groups of subjects with varying degrees of renal function based on creatinine clearance: normal renal function (>80 mL/min), mild renal impairment (51–80 mL/min), moderate renal impairment (30–50 mL/min), severe renal impairment (renal disease (ESRD) requiring hemodialysis. Serial blood samples for pharmacokinetic analyses were collected up to 12 days following a single 0.33 U/kg subcutaneous dose of LY2605541. The apparent clearance (CL/F) and half‐life across groups were not affected by renal function. Cmax values were lower in subjects with increasing severity of renal impairment; however, the small decrease in Cmax did not affect the overall exposure. Regression analysis showed that LY2605541 clearance is independent of renal function (slope = 0.000863; P = .885). The mean fraction of LY2605541 eliminated by a single hemodialysis session was 13% in subjects with ESRD. LY2605541 was generally well tolerated in healthy subjects and those with renal impairment following a single 0.33 U/kg subcutaneous dose. Given these data, no dose adjustment of LY2605541 based on pharmacokinetics is recommended in renal impairment or in patients undergoing hemodialysis. PMID:27163501

  17. New aspects for nuclear renal diagnosis

    International Nuclear Information System (INIS)

    Non-invasive nuclear methods of examination have gained great importance in renal diagnosis because they can be carried out without discomfort to the patient. Unilateral clearance is valuable in cases of unilateral renal damage where the impaired functioning of one kidney may be mashed by the compensatory action of the other, contralateral kidney. This is offen the case with chronic pyelonephritis, ureteral stenosis, and nephrolithiasis. In ectactic renal pelves, unilateral clearance should be obligatory, as functional assessment on the basis of the excretory urogram is impossible. The pathological X-ray picture often leads to false conclusions in this type of disease. Due to the low radiation exposure involved, close-meshed control examinations are possible which indicate functional changes early enough for the necessary therapy. The emphasis in scintiscanning has shifted to dynamic investigations. The main fields of application for sequential scintiscanning are unilateral and segmental renal diseases, differential diagnosis of anuria, traumatic changes, and emergency diagnoses in infants. Suspected growing and displacing processes are only an indirect indication for scintiscanning today. (orig.)

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

    OpenAIRE

    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...

  19. Renal (Kidney) Manifestations in TSC

    Medline Plus

    Full Text Available ... in TSC: renal cysts, renal angiomyolipoma and renal cell carcinoma . Renal angiomyolipomata, or angiomyolipomas, are usually the ... kidney failure, requiring dialysis or transplantation. Lastly, renal cell carcinoma, the least common renal association with TSC, ...

  20. Renal failure

    Institute of Scientific and Technical Information of China (English)

    1997-01-01

    970363 Effect on serum PTH and 1, 25(OH)2 D3levels of rapid correction of metabolic acidosis in CRFpatients with secondary hyperparathyroidism. YUANQunsheng(袁群生), et al. Renal Div, PUMC Hosp,Beijing, 100730. Chin J Nephrol 1996; 12(6): 328-331.

  1. Renal denervation

    DEFF Research Database (Denmark)

    Olsen, Lene Kjær; Kamper, Anne-Lise; Svendsen, Jesper Hastrup;

    2015-01-01

    PURPOSE OF REVIEW: Renal denervation (RDN) has, within recent years, been suggested as a novel treatment option for patients with resistant hypertension. This review summarizes the current knowledge on this procedure as well as limitations and questions that remain to be answered. RECENT FINDINGS...

  2. Over-estimation of glomerular filtration rate by single injection [51Cr]EDTA plasma clearance determination in patients with ascites

    DEFF Research Database (Denmark)

    Henriksen, Jens Henrik Sahl; Brøchner-Mortensen, J; Malchow-Møller, A;

    1980-01-01

    fluid-plasma activity ratio of [51Cr]EDTA increased throughout the investigation period (5h). The results suggest that [51Cr]EDTA equilibrates slowly with the peritoneal space which indicates that Clt will over-estimate the glomerular filtration rate by approximately 20 ml/min in patients with ascites....... To assess glomerular filtration rate in presence of ascites, the renal plasma clearance of [51Cr]EDTA should be used instead of the total plasma clearance....

  3. Clinical use of amylase clearance and isoamylase measurements.

    Science.gov (United States)

    Levitt, M D

    1979-07-01

    Isoamylase determinations and measurements of the ratio of the renal clearance of amylase relative to creatinine (CAm/CCr) were employed in an attempt to improve the diagnostic accuracy of the standard amylase measurement. An elevated CAm/CCr reflects defective proximal tubular reabsorption of amylase which occurs in virtually all patients with clear-cut acute pancreatitis. However, other conditions that apparently are associated with acute defective tubular function, such as burns and diabetic acidosis, may cause an elevated ratio. Thus, elevations of CAm/CCr cannot be considered to be specific for acute pancreatitis. Pancreatic isoamylase represents, on the average, about 33% of the normal serum amylase activity, whereas about 66% is salivary-type isoamylase. Isoamylase measurements are useful in determining whether an elevated value for serum amylase activity is of pancreatic origin. However, this measurement is not useful for determining whether patients with normal serum amylase activity have pancreatitis.

  4. The clearance concept with special reference to determination of glomerular filtration rate in patients with fluid retention.

    Science.gov (United States)

    Henriksen, Ulrik L; Henriksen, Jens H

    2015-01-01

    In subjects without fluid retention, the total plasma clearance of a renal filtration indicator (inulin, (99m) Tc-DTPA, (51) Cr-EDTA) is close to the urinary plasma clearance. Conversely, in patients with fluid retention (oedema, pleural effusions, ascites), there is a substantial discrepancy between the total plasma clearance and the urinary plasma clearance. This is owing to delayed indicator distribution to smaller or larger parts of the interstitial space, which in patients with ascites may simulate a peritoneal dialysator. In patients with fluid retention, urinary plasma clearance should be assessed to obtain a correct measurement of the glomerular filtration rate (GFR). In theory, total plasma clearance with late samples (24-h, 48-h) may be applied in patients with fluid retention, but validation hereof has not been performed. Until such studies are completed, it is recommended that patients with fluid retention have their GFR measured by a urinary plasma clearance technique with controlled quantitative urinary sampling within a few hours after indicator injection.

  5. Effects of flurbiprofen on renal function in patients with moderate renal insufficiency.

    Science.gov (United States)

    Murray, M D; Greene, P K; Brater, D C; Manatunga, A K; Hall, S D

    1992-01-01

    1. Renal function was assessed in eight patients with chronic renal insufficiency following the administration of flurbiprofen 50 mg as a single dose and after chronic administration of 50 mg four times daily for 8 and 27 days. Diet and fluid intake were controlled. 2. Inulin and creatinine clearances and urinary excretion of sodium were measured at baseline and every 20 min for at least 3 h after dosing. The time of the mean peak concentration of (S)-flurbiprofen was used to guide the analysis of the clearances. Creatinine clearance, urinary excretion of sodium, and serum sodium and potassium were also assessed for 24 h after the dose and on a daily basis. Body weight and blood pressure were measured on a daily basis. 3. Decrements in inulin and creatinine clearances were small and reversible within 3 h of an oral dose of flurbiprofen. Comparison of baseline clearances for the three study periods (first dose and at 8 and 27 days of chronic dosing) revealed a lack of chronic effect on glomerular filtration rate. 4. In contrast, flurbiprofen caused a substantial (73 to 86%) and progressive decrease in the urinary excretion of sodium that reached a nadir within 4-5 h after drug administration. However, comparison of baseline values did not differ, indicating that balance conditions had been re-established. 5. Results of 24 h assessments were in agreement with the clearance study results. Reduced urinary excretion of sodium appeared to be limited to the first few days of flurbiprofen administration.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:1576067

  6. Use of a Microsoft Excel based add-in program to calculate plasma sinistrin clearance by a two-compartment model analysis in dogs.

    Science.gov (United States)

    Steinbach, Sarah M L; Sturgess, Christopher P; Dunning, Mark D; Neiger, Reto

    2015-06-01

    Assessment of renal function by means of plasma clearance of a suitable marker has become standard procedure for estimation of glomerular filtration rate (GFR). Sinistrin, a polyfructan solely cleared by the kidney, is often used for this purpose. Pharmacokinetic modeling using adequate software is necessary to calculate disappearance rate and half-life of sinistrin. The purpose of this study was to describe the use of a Microsoft excel based add-in program to calculate plasma sinistrin clearance, as well as additional pharmacokinetic parameters such as transfer rates (k), half-life (t1/2) and volume of distribution (Vss) for sinistrin in dogs with varying degrees of renal function.

  7. Mechanism of increased renal clearnace of amylase/creatinine in acute pancreatitis.

    Science.gov (United States)

    Johnson, S G; Ellis, C J; Levitt, M D

    1976-11-25

    We investigated three possible causes of the increased ratio of amylase/creatinine clearance observed in acute pancreatitis. The presence of rapidly cleared isoamylase was excluded by studies of serum and urine, which demonstrated no anomalous isoamylases. In pancreatitis, the ratios (+/-1 S.E.M.) of both pancreatic isoamylase (9.2+/-0.6 per cent) and salivary isoamylase (8.6+/-1.6 per cent) were significantly (P less than 0.01) elevated over respective control values (2.4+/-0.2 and 1.8+/-0.2 per cent). Increased glomerular permeability to amylase was excluded by the demonstration of normal renal clearance of dextrans. We tested tubular reabsorption of protein by measuring the renal clearance of beta2-microglobulin, which is relatively freely filtered at the glomerulus and then avidly reabsorbed by the normal tubule. During acute pancreatitis the ratio of the renal clearance of beta2-microglobulin to that of creatinine was 1.22+/-0.52 per cent, an 80-fold increase over normal (0.015+/-0.002 per cent), with a rapid return toward normal during convalescence. Presumably, this reversible renal tubular defect also reduces amylase reabsorption and accounts for the elevated renal clearance of amylase/creatinine observed in acute pancreatitis.

  8. Beta 2-Microglobulin clearance as measured by radioimmunoassay

    Energy Technology Data Exchange (ETDEWEB)

    Woo, J.; Floyd, M.; Longley, M.A.; Cannon, D.C.

    1980-07-01

    We describe a radioimmunoassay for beta 2-microglobulin (beta 2 mu) in serum and urine. We incubated aliquots of diluted samples at room temperature for 1 h with /sup 125/I-labeled beta 2 mu and a rabbit antiserum monospecific for human beta 2 mu, and separated the phases by the double-antibody technique. The logit-log transformed dose-response curve was linear in the range 2 to 64 ng, equivalent to 0.5 to 16 mg/L of serum and 0.5 to 320 mg/L of urine. Assay sensitivity was 2.4 ng of beta 2 mu. Validation studies included tests of precision, accuracy, antibody specificity, and parallelism of the dose-response curves for standard and unknown. In a study of 25 normal individuals, serum and urine beta 2 mu ranged from 1.1 to 2.3 mg/L and 40 to 360 micrograms/24 h; the clearance of beta 2 mu was 8 to 130 microL/min. In 21 renal allograft recipients tested one to five weeks after transplantation, serum and urine beta 2 mu ranged from 3.9 to 15.6 mg/L and 7.2 to 611 mg/24 h; beta 2 mu clearance was 0.60 to 33.3 mL/min. Values for both serum and urine correlated well with severity of allograft rejection.

  9. The effects of cimetidine on creatinine excretion, glomerular filtration rate and tubular function in renal transplant recipients

    DEFF Research Database (Denmark)

    Olsen, N V; Ladefoged, S D; Feldt-Rasmussen, B;

    1989-01-01

    The renal clearance of endogenous creatinine (CCr), sodium (CNa) and lithium (CLi) was determined before and after a single intravenous bolus of cimetidine in nine renal transplant recipients. The glomerular filtration rate (GFR) was measured with 125I-iothalamate clearance (CTh). The initial CCr...... of sodium decreased throughout the study (p less than 0.05); CLi was unchanged. In conclusion cimetidine, when measured during 1-h clearance periods, interferes with tubular creatinine secretion in the denervated kidney of transplant recipients without affecting the glomerular filtration rate or proximal...

  10. 19 CFR 122.77 - Clearance certificate.

    Science.gov (United States)

    2010-04-01

    ... 19 Customs Duties 1 2010-04-01 2010-04-01 false Clearance certificate. 122.77 Section 122.77 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION, DEPARTMENT OF HOMELAND SECURITY; DEPARTMENT OF THE TREASURY AIR COMMERCE REGULATIONS Documents Required for Clearance and Permission To Depart;...

  11. 14 CFR 23.925 - Propeller clearance.

    Science.gov (United States)

    2010-01-01

    ... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Propeller clearance. 23.925 Section 23.925 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION AIRCRAFT AIRWORTHINESS STANDARDS: NORMAL, UTILITY, ACROBATIC, AND COMMUTER CATEGORY AIRPLANES Powerplant General § 23.925 Propeller clearance. Unless...

  12. Renal candidiasis

    International Nuclear Information System (INIS)

    Most fungal infections of the urinary tract are caused by Candida albicans, a yeast-like saprophytic fungus which may become apathogen under various conditions which lower the host resistance. The use of computed tomography in the diagnosis of renal fungus balls is the subject of this communication with emphasis on the radiologists role in the recognition of this entity. (H.W.). 6 refs.; 2 figs

  13. Renale Osteopathie

    OpenAIRE

    Horn S

    2001-01-01

    Die renale Osteopathie umfaßt Erkrankungen des Knochens, die bei Patienten mit chronischen Nierenerkrankungen auftreten, wie den sekundären bzw. tertiären Hyperparathyreoidismus, die adynamische Knochenerkrankung und die Osteopathie nach Nierentransplantation. Durch die Identifikation des Kalzium-Sensing-Rezeptors bzw. des Vitamin D-Rezeptors hat sich unser Verständnis der Zusammenhänge in den letzten Jahren erheblich verbessert. Neue Medikamente versprechen effizientere Prophylaxe- und Thera...

  14. Renale Knochenerkrankungen

    Directory of Open Access Journals (Sweden)

    Mayer G

    2008-01-01

    Full Text Available Störungen des Mineral- und Knochenstoffwechsels sind bei fast allen Patienten mit chronischen Nierenerkrankungen anzutreffen. Pathogenetisch spielt eine Neigung zur Phosphatretention bei einer Reduktion der glomerulären Filtrationsrate die zentrale Rolle. Neben typischen, aber sehr variablen Veränderungen der Knochenstruktur (renale Osteopathie besteht auch eine sehr enge Assoziation zwischen diesen Störungen und dem massiv erhöhten kardiovaskulären Risiko der Patienten.

  15. Obesity and renal hemodynamics

    NARCIS (Netherlands)

    Bosma, R. J.; Krikken, J. A.; van der Heide, J. J. Homan; de Jong, P. E.; Navis, G. J.

    2006-01-01

    Obesity is a risk factor for renal damage in native kidney disease and in renal transplant recipients. Obesity is associated with several renal risk factors such as hypertension and diabetes that may convey renal risk, but obesity is also associated with an unfavorable renal hemodynamic profile inde

  16. Sulphasalazine induced renal failure.

    OpenAIRE

    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.

  17. Effects of Chinese herbal enema therapy combined basic treatment on BUN,SCr,UA,and IS in chronic renal failure patients

    Institute of Scientific and Technical Information of China (English)

    邹川

    2012-01-01

    Objective To assess the clearance role and safety of Chinese herbal enema therapy (CHET) in clearing enterogenic uremic toxins in chronic renal failure (CRF) patients,thus providing evidence for further optimizing the comprehensive treatment. Methods Using nonrandomized concurrent control

  18. Proximal renal tubular acidosis

    Science.gov (United States)

    Renal tubular acidosis - proximal; Type II RTA; RTA - proximal; Renal tubular acidosis type II ... are neutralized by alkaline substances, mainly bicarbonate. Proximal renal tubular acidosis (Type II RTA) occurs when bicarbonate ...

  19. Distal renal tubular acidosis

    Science.gov (United States)

    Renal tubular acidosis - distal; Renal tubular acidosis type I; Type I RTA; RTA - distal; Classical RTA ... blood and excreting it into the urine. Distal renal tubular acidosis (Type I RTA) is caused by ...

  20. Single-dose pharmacokinetics and safety of pegylated interferon-alpha2b in patients with chronic renal dysfunction.

    Science.gov (United States)

    Gupta, Samir K; Pittenger, Amy L; Swan, Suzanne K; Marbury, Thomas C; Tobillo, Emlyn; Batra, Vijay; Sack, Marshall; Glue, Paul; Jacobs, Sheila; Affrime, Melton

    2002-10-01

    This study evaluates the pharmacokinetics and safety of pegylated interferon-alpha2b (PEG-Intron) following a single-dose subcutaneous injection into subjects with normal renal function, subjects with chronic renal impairment, and patients on hemodialysis. In this open-label, single-dose, parallel group study, subjects were divided into five groups according to their degree of renal function: four groups as defined by measured creatinine clearance and a fifth hemodialysis dependent group. They received 1 microg/kg PEG-Intron subcutaneously after a 10-hour fast. Pharmacokinetic and safety assessments were performed up to 168 hours postdose. Hemodialysis patients had a second PEG-Intron dose 12 hours prior to a hemodialysis session. PEG-Intron pharmacokinetic parameters (AUCtf, Cmax, and t1/2) increased progressively as CL(CR) declined. All subjects reported at least one adverse event, which were typical of those reported after alpha-interferon administration (e.g., flu-like symptoms, headache). Single-dose PEG-Intron administration to volunteers with normal renal function and chronic renal impairment was safe and well tolerated. In patients with CL(CR) < 30 ml/min, AUCand Cmax values were increased 90% compared with controls, while half-life was increased by up to 40% over controls. Based on the relationship between PEG-Intron apparent clearance and CL(CR), renal clearance accountsfor less than half of its total clearance. Hemodialysis did not affect PEG-Intron apparent clearance.

  1. Uses and limitations of renal scintigraphy in renal transplantation monitoring

    Energy Technology Data Exchange (ETDEWEB)

    Heaf, J.G. [Department of Nephrology, Herlev Hospital, University of Copenhagen (Denmark); Iversen, J. [Department of Clinical Physiology, Herlev Hospital, University of Copenhagen (Denmark)

    2000-07-01

    The value of thrice weekly technetium-99m mercaptoacetyltriglycine renography after renal transplantation was investigated in 213 consecutive transplants. A grading system was used: 0 = normal renogram; 1 = normal uptake, reduced excretion; 2 = normal uptake, flat excretion curve; 3 = rising curve; 4 = reduced rate of uptake, rising curve and reduced absolute uptake; 5 = minimal uptake. The initial renogram grade (RG) was primarily a marker of ischaemic damage, being poorer with cadaver donation, long cold ischaemia (>24 h), and high donor and recipient age. High primary RG predicted primary graft non-function, long time to graft function, low discharge Cr EDTA clearance and low 1- and 5-year graft survival. Discharge RG predicted late (>6 months) graft loss. RG was highly correlated (P<0.001) with creatinine and creatinine clearance, and changes in RG were correlated with changes in renal function. A change in RG of 0.5 was non-specific, while a change of 1 or more predicted clinical complications in 95% of cases. The negative predictive value was low (58%). RG change antedated clinical diagnosis in only 38% of cases, and in only 14% of acute rejections did an RG change of 1 or more antedate a rising creatinine. RG did not contribute to the differential diagnosis between acute rejection, acute tubulointerstitial nephropathy and cyclosporine toxicity. In conclusion, an initial renography after transplantation is valuable as it measures ischaemic damage and predicts duration of graft non-function and both short and long-term graft survival. A review of the literature suggests that the indication for serial scintigraphic monitoring for functioning grafts is less certain: the diagnostic specificity is insufficient for it to be the definitive investigation for common diagnostic problems and it does not give sufficient advance warning of impending problems. (orig.)

  2. SKIN KINETICS AND DERMAL CLEARANCE

    Directory of Open Access Journals (Sweden)

    Prakash Shashi

    2012-08-01

    Full Text Available Availability of several therapeutic and cosmetic formulations for topical application has made the research on skin kinetics as a topic of current interest. Topical formulations are typically meant for local effect although there is always a chance that the low molecular weight chemicals are easily transported across the skin layer and make it available in the systemic circulation. Thus there is a major concern about the transport of chemical moieties following the topical application of cosmetics and therapeutic formulations and the real time measurement of the molecules in the skin layer has become obligatory. It is well known that the properties of both drug and the excipients have identical role in determining the skin permeability of chemical moieties. In the last decade several investigations have been carried out in this filed using several in vitro and in vivo models. This review provides a brief account on the basics of skin kinetics, parameters assessed, various techniques and methods adapted in skin kinetic studies. Moreover, we have also discussed about the micro-environment inside the skin layer and the possible mechanism of drug depot formation, skin metabolism and clearance of molecules from the skin layers.

  3. Nucleotide-mediated airway clearance.

    Science.gov (United States)

    Schmid, Andreas; Clunes, Lucy A; Salathe, Mathias; Verdugo, Pedro; Dietl, Paul; Davis, C William; Tarran, Robert

    2011-01-01

    A thin layer of airway surface liquid (ASL) lines the entire surface of the lung and is the first point of contact between the lung and the environment. Surfactants contained within this layer are secreted in the alveolar region and are required to maintain a low surface tension and to prevent alveolar collapse. Mucins are secreted into the ASL throughout the respiratory tract and serve to intercept inhaled pathogens, allergens and toxins. Their removal by mucociliary clearance (MCC) is facilitated by cilia beating and hydration of the ASL by active ion transport. Throughout the lung, secretion, ion transport and cilia beating are under purinergic control. Pulmonary epithelia release ATP into the ASL which acts in an autocrine fashion on P2Y(2) (ATP) receptors. The enzymatic network describes in Chap. 2 then mounts a secondary wave of signaling by surface conversion of ATP into adenosine (ADO), which induces A(2B) (ADO) receptor-mediated responses. This chapter offers a comprehensive description of MCC and the extensive ramifications of the purinergic signaling network on pulmonary surfaces. PMID:21560046

  4. Prediction of differential creatinine clearance in chronically obstructed kidneys by non-contrast helical computerized tomography

    Directory of Open Access Journals (Sweden)

    Ng C.F.

    2004-01-01

    Full Text Available PURPOSE: We investigate the use of non-contrast helical computerized tomography (NCHCT in the measurement of differential renal parenchymal volume as a surrogate for differential creatinine clearance (CrCl for unilateral chronically obstructed kidney. MATERIALS AND METHODS: Patients with unilateral chronically obstructed kidneys with normal contralateral kidneys were enrolled. Ultrasonography (USG of the kidneys was first done with the cortical thickness of the site with the most renal substance in the upper pole, mid-kidney, and lower pole of both kidneys were measured, and the mean cortical thickness of each kidney was calculated. NCHCT was subsequently performed for each patient. The CT images were individually reviewed with the area of renal parenchyma measured for each kidney. Then the volume of the slices was summated to give the renal parenchymal volume of both the obstructed and normal kidneys. Finally, a percutaneous nephrostomy (PCN was inserted to the obstructed kidney, and CrCl of both the obstructed kidney (PCN urine and the normal side (voided urine were measured two 2 after the relief of obstruction. RESULTS: From March 1999 to February 2001, thirty patients were enrolled into the study. Ninety percent of them had ureteral calculi. The differential CrCl of the obstructed kidney (%CrCl was defined as the percentage of CrCl of the obstructed kidney as of the total CrCl, measured 2 weeks after relief of obstruction. The differential renal parenchymal volume of the obstructed kidney (%CTvol was the percentage of renal parenchymal volume as of the total parenchymal volume. The differential USG cortical thickness of the obstructed kidney (%USGcort was the percentage of mean cortical thickness as of the total mean cortical thickness. The Pearson's correlation coefficient (r between %CTvol and %CrCl and that between %USGcort and %CrCl were 0.756 and 0.543 respectively. The regression line was %CrCl = (1.00 x %CTvol - 14.27. The %CTvol

  5. [Sensitivity and specificity of blood amylase, amylase and creatinine clearance ratio and urinary amylase/urinary creatinine ratio in the diagnosis of acute pancreatitis].

    Science.gov (United States)

    Ligny, G; Meunier, J C; Hayard, P; Ligny, C; Van Cauter, J

    1987-12-01

    The sensitivity and specificity of amylasemia, the ratios of amylase/creatinine clearance and amylasuria/creatininuria were determined in four groups of patients: a control group (n = 43), patients with acute pancreatitis detected on computed tomography (n = 30, 25 cases of alcoholic pancreatitis), patients with an acute surgical abdomen without pancreatitis (n = 25), and patients with renal failure (n = 20). Sensitivity was defined for the acute pancreatitis group and specificity for the other groups. When amylasemia was greater than 20 UI/dl and the amylasuria/creatininuria ratio greater than 100, sensitivity was 98 per cent. The specificity of these two results in patients with an acute surgical abdomen was 98 per cent. When the ratio amylase/creatinine clearance ratio was greater than 4 sensitivity was 73 per cent and specificity in patients with acute surgical abdomen was 75 per cent. These two values were lower than those of the two preceding tests (p less than 0.01). Sensitivity of the association of an amylasemia greater than 13 UI/dl (m + 2SD) with a clearance ratio greater than 4 was 73 per cent. The amylase/creatinine clearance ratio did not seem to be reliable since its change was delayed with respect to the increase of amylasemia and amylasuria. This ratio has a poor specificity as it increased when the clearance of creatinine decreased in the group with an acute surgical abdomen associated with functional or organic renal failure. In these two groups, the correlation between the amylase/creatinine clearance ratio and creatininemia was significant. This suggested that the clearance of creatinine fell more rapidly than the clearance of amylase as renal failure increased.

  6. Pharmacomechanical thrombolysis for renal salvage after filter migration and renal vein thrombosis.

    Science.gov (United States)

    Kiguchi, Misaki; McDonald, Kerry-Ann; Govindarajan, Siddarth; Makaroun, Michel S; Chaer, Rabih A

    2011-05-01

    A 64-year-old woman underwent prophylactic inferior vena cava filter placement immediately after spinal surgery for pulmonary embolus prophylaxis. One week after surgery, acute renal failure developed, and she required hemodialysis secondary to filter migration with iliocaval and renal vein thrombosis. Pharmacomechanical thrombolysis was performed, with complete recovery of renal function and no evidence of recurrence on follow-up imaging. This report highlights an important and rare complication of filter placement and the importance of prompt thrombus debulking to preserve end organ function while reducing the risks of hemorrhagic complications. Pharmacomechanical thrombolysis allows prompt clearance of venous outflow channels and is attractive in patients with end-organ compromise and high risk for bleeding.

  7. Renale Osteopathie

    Directory of Open Access Journals (Sweden)

    Horn S

    2001-01-01

    Full Text Available Die renale Osteopathie umfaßt Erkrankungen des Knochens, die bei Patienten mit chronischen Nierenerkrankungen auftreten, wie den sekundären bzw. tertiären Hyperparathyreoidismus, die adynamische Knochenerkrankung und die Osteopathie nach Nierentransplantation. Durch die Identifikation des Kalzium-Sensing-Rezeptors bzw. des Vitamin D-Rezeptors hat sich unser Verständnis der Zusammenhänge in den letzten Jahren erheblich verbessert. Neue Medikamente versprechen effizientere Prophylaxe- und Therapiemöglichkeiten. Wir beeinflussen dadurch nicht nur die Morbidität und Lebensqualität, sondern auch die Mortalität unserer Patienten.

  8. A STUDY ON EGFR, CREATININE CLEARANCE & URINARY PROTEIN TO CREATININE RATIO IN CKD

    Directory of Open Access Journals (Sweden)

    Ganga Bhavani

    2014-05-01

    Full Text Available There was a good correlation between Glomerular Filtration Rate (GFR values estimated by any of the 3 methods. Crcl correlated better with Cockcroft-Gault (CG eGFR than Modification of Diet in Renal Disease (MDRD eGFR and there was also a very good correlation between CG eGFR and MDRD eGFR. Based on this result we feel that in advanced CKD all 3 methods give similar GFR estimates but in earlier stages of Chronic Kidney Disease (CKD Creatinine clearance (Crcl gives higher estimate of GFR. Thus use of Crcl may wrongly classify patients into less severe stages of CKD which might lead to delay in initiation of proper treatment. MATERIALS AND METHODS: CKD patients were selected on the basis of serum creatinine levels. S.C > 2.5 mg/dl values were considered to be having CKD. 75 Samples were tested. Both males & females patients are taken in this study. Serum Creatinine & Urinary Creatinine by Jaffe’s method, Blood Urea by Urease method, Urinary Protein by Pyrogallol red method, estimation of GFR by three methods. Creatinine Clearance &eGFR by using Cockcroft- Gault& MDRD equations. RESULT: A total of 75 patients attending the nephrology department (P.E.S Medical College, Kuppamfor treatment and monitoring for chronic kidney disease where included in the present study. Serum creatinine, serum urea and creatinine clearance were measured in all these patients as per methods described under materials and methods. Estimated GFR (eGFR using CG (Cock croft and MDRD (Modification of Diet in renal disease formulae were calculated. Majority of the cases were complications due to long standing diabetes mellitus or hypertension. CONCLUSION: Creatinine Clearance over estimates GFR in early stages of CKD. Use of Crcl to assess GFR may not be proper to classify CKD into different stages. Any of the 3 methods (Crcl, CG eGFR and MDRD eGFR can be used as markers of GFR in advanced stages of CKD. MDRD eGFR is a better indicator of eGFR for staging CKD in early stages

  9. Differential effect of T-type voltage-gated calcium channel disruption on renal plasma flow and glomerular filtration rate in vivo

    DEFF Research Database (Denmark)

    Thuesen, Anne D; Andersen, Henrik; Cardel, Majken;

    2014-01-01

    of two T-type Cav knock-out mice strains. Continuous recordings of blood pressure and heart rate, and para-aminohippurate clearance (renal plasma flow) and inulin clearance (GFR) were performed in conscious, chronically catheterized, wild type and Cav 3.1-/- and Cav 3.2-/- mice. Contractility of afferent...

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

    International Nuclear Information System (INIS)

    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.)

  11. INTER- RELATIONSHIP BETWEEN THYROID AND RENAL PROFILE IN OVERT HYPOTHYROIDISM

    Directory of Open Access Journals (Sweden)

    Mohammed Ali

    2015-11-01

    Full Text Available BACKGROUND: Renal function is altered by thyroid status. Therefore, this study was done to determine the relationship between thyroid and renal parameters in overt type of thyroid dysfunction. AIM: The aims of this study were to correlate parameters of serum creatinine, creatinine clearance, with serum T3, T4 and TSH in overt hypothyroid cases. MATERIALS AND METHODS: This Case control study included fifty diagnosed cases of hypothyroidism in the department of Endocrinology, Medicine and Surgery of A J Institute of Medical Sciences & Research Centre, Mangaluru, of age group 15-75 years. Based on TSH levels, subjects were classified as subclinical hypothyroids and overt hypothyroids. Results were compared with age and sex matched twenty five euthyroids. Serum T3, T4 and TSH; Serum creatinine; and Creatinine clearance were estimated and analysed. RESULTS: The results of the present study were obtained from 75subjects out of whom 25 were controls, 22 were subclinical hypothyroids and 28 were overt hypothyroids. Age distribution of study subjects shows that the mean age was 39.56±13.019 for overt hypothyroids. Sex distribution of study subjects shows that majority of overt hypothyroids (78.6% were females. Percentage of individuals with altered serum creatinine, and creatinine clearance among overt hypothyroids shows that there were more cases of overt hypothyroids with increased serum creatinine. Hypothyroid cases had decreased renal function. Overt hypothyroids showed statistically significant difference in the levels of serum creatinine, but they did not differ in the levels of creatinine clearance. CONCLUSION: Hypothyroidism is linked with considerable derangement in biochemical parameters of renal function, necessitating regularl monitoring of renal pararmeters in hypothyroid patients.

  12. Deposition of aerosols and bronchial clearance measurements

    International Nuclear Information System (INIS)

    A special inhalative device is described for reproducible deposition patterns of radioactive aerosols to measure mucociliary and tussive clearance and to evaluate the effect of drugs on the bronchial tree is described. Additive actions on mucus transport exist between β2-agonists and theophylline, but not incombination with inhalative quarternary ammonium compounds (ipatropium and oxitropium bromide). Mucolytics are generally less effective on mucociliary clearance than β2-agonists and theophylline, positive, negative and nonresponders are ofter seen due to the different viscoelastic properties of the mucus. Mucus transport is more than mucociliary clearance. Two-phase gas/liquid movement and coughing are also important transport mechanisms for bronchial mucus. Therefore, bronchodilators enhance mucus transport by increasing airway patency, which increases total and regional air flow and improves cough clearance. (orig.)

  13. Renal calculus

    CERN Document Server

    Pyrah, Leslie N

    1979-01-01

    Stone in the urinary tract has fascinated the medical profession from the earliest times and has played an important part in the development of surgery. The earliest major planned operations were for the removal of vesical calculus; renal and ureteric calculi provided the first stimulus for the radiological investigation of the viscera, and the biochemical investigation of the causes of calculus formation has been the training ground for surgeons interested in metabolic disorders. It is therefore no surprise that stone has been the subject of a number of monographs by eminent urologists, but the rapid development of knowledge has made it possible for each one of these authors to produce something new. There is still a technical challenge to the surgeon in the removal of renal calculi, and on this topic we are always glad to have the advice of a master craftsman; but inevitably much of the interest centres on the elucidation of the causes of stone formation and its prevention. Professor Pyrah has had a long an...

  14. Renal involvement in dogs with babesiosis

    Directory of Open Access Journals (Sweden)

    R.G. Lobetti

    2001-07-01

    Full Text Available Proteinuria, and renal tubular casts and epithelial cells in urine sediment, are commonly observed in both complicated and uncomplicated babesiosis, but do not necessarily reflect or predict renal failure. This study investigated the presence and degree of renal damage in canine babesiosis. Renal function and integrity were evaluated using serum urea and creatinine, serum electrolytes (sodium and potassium, fractional clearance of sodium (FcNa and potassium (FcK, urine enzyme activity of gamma-glutamyl transpeptidase and alkaline phosphatase, urine protein:creatinine ratio, and urinalysis. One control group (n =10 and 3 groups of babesiosis cases were studied: mild uncomplicated (n =10, severe uncomplicated (n = 11, and complicated (n = 9. All babesiosis groups showed well-concentrated urine. Mean serum urea was elevated in the severe and complicated groups, and was significantly different from the control group. There was no statistically significant difference between the groups for creatinine, although the complicated group had a mean value above the normal reference range. Hypokalaemia was uncommon in all the groups. Hyperkalaemia was present in only 2 dogs in the complicated group. Marginal hyponatraemia was present in a minority of dogs in all groups. The serumelectrolytes were not significantly different between groups. There was no overall elevation, nor any statistically significant difference in both the FcNa and FcK between the groups. Only 1 dog, in the complicated group, showed marked enzymuria. Proteinuria was a common finding and was significantly different between the severe and complicated groups and the control group. Some dogs in all groups had renal tubular epithelial cells in the urinary sediment, which increased in severity from the mild to the complicated groups and was significantly different from the control group. This study demonstrated that minimal renal damage occurs more often in canine babesiosis than significant

  15. Paid Living-Unrelated Renal Transplantation Abroad: Too Much Unknown

    Directory of Open Access Journals (Sweden)

    Yalçın SOLAK

    2012-05-01

    Full Text Available OBJECTIVE: Despite the unethical characteristic and unfavorable consequences, paid livingunrelated renal transplantation is still considered as an option for end-stage renal disease patients. This study aimed to compare the medical and surgical complications along with allograft functions of PLURT patients with age and gender matched transplant recipients who received a living or deceased donor kidney at our center. MATERIAL and METHODS: End-stage renal disease patients received PLURT (group 1 in a foreign country and age, and gender matched renal transplant recipients that received renal transplantation from living-related donors (LRT patients; group 2 and deceased donors (DDRT patients; group 3 followed between 2003-2010 at our transplantation center were included in the study. RESULTS: There were no significant differences between groups (Group 1&2 and group 1&3 regarding age, sex, urea, creatinine, creatinine clearance, and proteinuria. Data about patients that received renal transplantation from living-related and deceased-donors at our center were sufficient when compared with PLURT patients. PLURT has a negative impact on patients' survival because of surgical and medical problems. CONCLUSION: In the present study, PLURT, LRT and DDRT patients had early and late complications of renal transplantation which were similarly seen in recent studies. The main problem for unfavorable results of PLURT is the commercial aspect of renal transplantation without considering the risks for ESRD patients.

  16. Association of Continuous-Equivalent Urea Clearances with Death Risk in Intermittent Hemodialysis

    Directory of Open Access Journals (Sweden)

    Aarne Vartia

    2016-01-01

    Full Text Available Background. Several reports describe favorable results from frequent hemodialysis, but due to the lack of unequivocal dose measures it is not clear whether the benefits are due to more efficient toxin removal or other factors. Methods. The associations with death risk of six continuous-equivalent urea clearance measures were compared in 57 conventional in-center hemodialysis treatment periods of 51 patients, together 114 patient years. The double pool dose measures were calculated with the Solute-Solver program and separately scaled to urea distribution volume or normalized with body surface area. Results. Mortality associated significantly with equivalent renal urea clearance (EKR scaled to urea distribution volume (V (p=0.033 and with EKR normalized with body surface area (BSA (p=0.044 but not with V-scaled (p=0.059 nor BSA-normalized (p=0.183 standard clearance (stdK. Women had significantly higher normalized protein catabolic rate (nPCR, EKR/V, and stdK/V than men but slightly lower BSA-normalized dose measures and lower mortality. Protein catabolic rate and dialysis dose correlated positively with each other and with survival. Conclusions. The prognostically most valid continuous-equivalent clearance in the present material was EKR/V, calculated from double pool urea generation rate, distribution volume, and time-averaged concentration.

  17. A case of delayed methotrexate clearance following administration of a complementary medication containing chlorophyll.

    Science.gov (United States)

    Brooks, Sally L; Sanders, Julie; Seymour, John F; Mellor, James D

    2014-06-01

    A 54-year-old male with relapsed primary cerebral lymphoma and normal renal function was treated with methotrexate (MTX) 3 g/m(2) monthly by intravenous infusion. Throughout treatment the patient self-administered a complementary medicine (Jason Winter's chlorophyll®), which he was advised to cease during methotrexate treatment due to the potential for unknown interactions. For the first four cycles, chlorophyll was ceased two days prior to commencement of methotrexate and withheld until clearance. These cycles were administered without complication, and the methotrexate level reduced to chlorophyll was not ceased and there were no changes to concomitant medications. A literature search found no documented interactions between methotrexate and chlorophyll and the chemotherapy was administered without a delay in treatment. The methotrexate level three days post-administration was 0.36 µmol/L and did not reduce to chlorophyll 48 h prior to methotrexate administration until clearance. There were no further episodes of delayed methotrexate clearance. No impurities were detected in a sample of Jason Winter's chlorophyll®. It is therefore likely that the patient's delayed methotrexate clearance was due to an interaction with chlorophyll. It is recommended that such chlorophyll containing preparations be avoided in patients treated with methotrexate.

  18. Renal actinomycosis with concomitant renal vein thrombosis.

    Science.gov (United States)

    Chang, Dong-Suk; Jang, Won Ik; Jung, Ji Yoon; Chung, Sarah; Choi, Dae Eun; Na, Ki-Ryang; Lee, Kang Wook; Shin, Yong-Tai

    2012-02-01

    Renal actinomycosis is a rare infection caused by fungi of the genus Actinomyces. A 74-year-old male was admitted to our hospital because of gross hematuria with urinary symptoms and intermittent chills. Computed tomography of the abdomen showed thrombosis in the left renal vein and diffuse, heterogeneous enlargement of the left kidney. After nephrectomy, sulfur granules with chronic suppurative inflammation were seen microscopically, and the histopathological diagnosis was renal actinomycosis. Our case is the first report of renal actinomycosis with renal vein thrombosis.

  19. 48 CFR 801.602-76 - Business clearance review.

    Science.gov (United States)

    2010-10-01

    ... obtain a business clearance review prior to award of any contract, task or delivery order, or blanket... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Business clearance review... Authority, and Responsibilities 801.602-76 Business clearance review. (a) A business clearance review is...

  20. Understanding renal replacement therapy and dosing of drugs in pediatric patients with kidney disease.

    Science.gov (United States)

    Zuppa, Athena F

    2012-01-01

    Multifaceted factors need to be considered when prescribing renal replacement therapy (RRT) and dosing of drugs in pediatric patients with kidney disease. RRTs in pediatrics such as intermittent hemodialysis, continuous venovenous hemofiltration, continuous venovenous hemodialysis, and continuous venovenous hemodiafiltration affect solute and drug clearance. Drug properties such as molecular weight, molecular charge, volume of distribution, and protein binding affect drug clearance. RRT prescription parameters such as blood flow rate, ultrafiltration rate, membrane size, and pore size can also influence drug clearance. Furthermore, the pediatric patient presents additional concerns because of developmental factors in children that affect both pharmacokinetics of drugs.

  1. TRANSPLANTE RENAL

    Directory of Open Access Journals (Sweden)

    Soraia Geraldo Rozza Lopes

    2014-01-01

    Full Text Available El objetivo del estudio fue comprender el significado de espera del trasplante renal para las mujeres en hemodiálisis. Se trata de un estudio cualitativo-interpretativo, realizado con 12 mujeres en hemodiálisis en Florianópolis. Los datos fueron recolectados a través de entrevistas en profundidad en el domicilio. Fue utilizado el software Etnografh 6.0 para la pre-codificación y posterior al análisis interpretativo emergieron dos categorías: “las sombras del momento actual”, que mostró que las dificultades iniciales de la enfermedad están presentes, pero las mujeres pueden hacer frente mejor a la enfermedad y el tratamiento. La segunda categoría, “la luz del trasplante renal”, muestra la esperanza impulsada por la entrada en la lista de espera para un trasplante.

  2. Renal failure

    Institute of Scientific and Technical Information of China (English)

    1993-01-01

    930564 Dwell times affect the local host de-fence mechanism of peritoneal dialysis patients.WANG Tao(汪涛),et al.Renal Instit,SunYatsen Med Univ,Guangzhou,510080.Chin JNephrol 1993;9(2):75—77.The effect of different intraperitoneal awelltimes on the local host defence in 6 peritonealdialysis patients was studied.A significant de-crease in the number of peritoneal cells,IgG con-centration and the phagoeytosis and bactericidalactivity of macrophages was determined when thedwell time decreased from 12 to 4 hs or form 4 to0.5hs,but the peroxidase activity in macrophagesincreased significantly.All variables,except theperoxidase activity in macrophages,showed nosignificant difference between patients of high or

  3. Trypsin/creatinine clearance ratio and serum immunoreactive trypsin in digestive and pancreatic diseases.

    Science.gov (United States)

    Del Favero, G; Fabris, C; Bonvicini, P; Piccoli, A; Baccaglini, U; Pedrazzoli, S; Burlina, A; Naccarato, R

    1985-01-01

    The behavior of trypsin/creatinine clearance ratio (Ctr/Ccr) and serum immunoreactive trypsin (IRT) was evaluated in a total of 168 subjects with pancreatic cancer, chronic pancreatitis and non-pancreatic digestive diseases. Amylase/creatinine clearance ratio (Cam/Ccr) and serum amylase levels were also evaluated in order to establish their possible relationship with Ctr/Ccr and IRT values. Elevated Ctr/Ccr and IRT values were observed in several patients with pancreatic cancer and chronic pancreatitis. Abnormal IRT and Ctr/Ccr values were found in 28.2 and 4% of non-pancreatic digestive diseases, respectively. IRT and amylase serum levels showed consensual modifications, while Ctr/Ccr showed a behavior different from that of Cam/Ccr. Liver damage seems to play a role in increasing serum IRT levels of patients without pancreatic involvement, while the increased Ctr/Ccr seems to depend on other factors, for instance renal tubular dysfunction.

  4. High-NaCl diet impairs dynamic renal blood flow autoregulation in rats with adenine-induced chronic renal failure

    DEFF Research Database (Denmark)

    Saeed, Aso; DiBona, Gerald F; Grimberg, Elisabeth;

    2014-01-01

    This study examined the effects of 2 wk of high-NaCl diet on kidney function and dynamic renal blood flow autoregulation (RBFA) in rats with adenine-induced chronic renal failure (ACRF). Male Sprague-Dawley rats received either chow containing adenine or were pair-fed an identical diet without...... increase the susceptibility to hypertensive end-organ injury and progressive renal failure by facilitating pressure transmission to the microvasculature....... adenine (controls). After 10 wk, rats were randomized to either remain on the same diet (0.6% NaCl) or to be switched to high 4% NaCl chow. Two weeks after randomization, renal clearance experiments were performed under isoflurane anesthesia and dynamic RBFA, baroreflex sensitivity (BRS), systolic...

  5. Relationship of glomerular filtration rate based on serum iodixanol clearance to IRIS staging in cats with chronic kidney disease

    OpenAIRE

    IWAMA, Ryosuke; SATO, Tsubasa; Katayama, Masaaki; Shimamura, Shunsuke; SATOH, Hiroshi; ICHIJO, Toshihiro; FURUHAMA, Kazuhisa

    2015-01-01

    We examined the correlation between the glomerular filtration rate (GFR) estimated from an equation based on the serum iodixanol clearance technique and International Renal Interest Society (IRIS) stages of chronic kidney disease (CKD) in cats. The equation included the injection dose, sampling time, serum concentration and estimated volume of distribution (Vd) of the isotonic, nonionic, contrast medium iodixanol as a test tracer. The percent changes in the median basal GFR values calculated ...

  6. Amylase-creatinine clearance ratio. A simple test to predict gentamicin nephrotoxicity.

    Science.gov (United States)

    Aderka, D; Tene, M; Graff, E; Levo, Y

    1988-05-01

    The initial target of aminoglycoside nephrotoxicity is the proximal tubule. Yet, no simple test is available to predict such toxicity. Taking advantage of the fact that amylase is filtered in the glomerulus and reabsorbed by the proximal tubules, we prospectively examined in 23 patients if changes in renal amylase creatinine clearance ratio (ACCR) can predict gentamicin nephrotoxicity. Eighteen of these patients had an initial creatinine clearance (rCcr) above 30 mL/min. Eleven of them (group A) had an ACCR above 3.5% (control 3% +/- 1.03%) and all exhibited an average reduction of 32.2% +/- 11.6% in rCcr following one week of gentamicin therapy. In contrast, only one of seven patients (group B) with an initial ACCR below 3.5% had a reduction, albeit transient, in rCcr. During gentamicin therapy, group A patients had a further increase in ACCR which was proportional to the reduction observed in rCcr (r = -.54). Our preliminary data suggest that ACCR may prove a simple and possibly a reliable predictor of kidney function deterioration during gentamicin therapy in patients with rCcr above 30 mL/min: patients with pretherapy ACCR above 3.5% may exhibit a deterioration in the creatinine clearance during the first week of therapy. For patients with pretherapy renal failure (rCcr less than 30 mL/min) the creatinine levels (but not the ACCR) seem to retain their significance in predicting and monitoring further renal function deterioration during aminoglycoside therapy.

  7. Amylase-creatinine clearance ratio. A simple test to predict gentamicin nephrotoxicity.

    Science.gov (United States)

    Aderka, D; Tene, M; Graff, E; Levo, Y

    1988-05-01

    The initial target of aminoglycoside nephrotoxicity is the proximal tubule. Yet, no simple test is available to predict such toxicity. Taking advantage of the fact that amylase is filtered in the glomerulus and reabsorbed by the proximal tubules, we prospectively examined in 23 patients if changes in renal amylase creatinine clearance ratio (ACCR) can predict gentamicin nephrotoxicity. Eighteen of these patients had an initial creatinine clearance (rCcr) above 30 mL/min. Eleven of them (group A) had an ACCR above 3.5% (control 3% +/- 1.03%) and all exhibited an average reduction of 32.2% +/- 11.6% in rCcr following one week of gentamicin therapy. In contrast, only one of seven patients (group B) with an initial ACCR below 3.5% had a reduction, albeit transient, in rCcr. During gentamicin therapy, group A patients had a further increase in ACCR which was proportional to the reduction observed in rCcr (r = -.54). Our preliminary data suggest that ACCR may prove a simple and possibly a reliable predictor of kidney function deterioration during gentamicin therapy in patients with rCcr above 30 mL/min: patients with pretherapy ACCR above 3.5% may exhibit a deterioration in the creatinine clearance during the first week of therapy. For patients with pretherapy renal failure (rCcr less than 30 mL/min) the creatinine levels (but not the ACCR) seem to retain their significance in predicting and monitoring further renal function deterioration during aminoglycoside therapy. PMID:2452611

  8. Does a Nephron Deficit Exacerbate the Renal and Cardiovascular Effects of Obesity?

    OpenAIRE

    Seshini Gurusinghe; Brown, Russell D.; Xiaochu Cai; Samuel, Chrishan S.; Ricardo, Sharon D.; Thomas, Merlin C.; Kett, Michelle M

    2013-01-01

    It has been hypothesized that a reduced nephron endowment exacerbates the hypertensive and renal effects of obesity. We therefore examined the impact of diet-induced obesity on renal structure and function, and arterial pressure in a genetic model of reduced nephron endowment, the GDNF Heterozygous (HET) mouse. 6 wk-old male GDNF WT and HET mice were placed on control or high fat (HFF) diet for 20 weeks. 24 hr arterial pressure, heart rate and activity (radiotelemetry), creatinine clearance a...

  9. eGFR is a reliable preoperative renal function parameter in patients with gastric cancer

    Institute of Scientific and Technical Information of China (English)

    Takayuki; Kosuge; Tokihiko; Sawada; Yoshimi; Iwasaki; Junji; Kita; Mitsugi; Shimoda; Nobumi; Tagaya; Keiichi; Kubota

    2010-01-01

    AIM: To evaluate the validity of the estimated glomerular filtration rate (eGFR) as a preoperative renal function parameter in patients with gastric cancer. METHODS: A retrospective study was conducted in 147 patients with gastric cancer. Preoperative creatinine clearance (Ccr), eGFR, and preand postoperative serum creatinine (sCr) data were examined. Preoperative Ccr and eGFR were then compared for their reliability in predicting postoperative renal dysfunction. RESULTS: Among 110 patients with normal preo...

  10. Nitric oxide and prostanoids protect the renal outer medulla from radiocontrast toxicity in the rat.

    OpenAIRE

    Agmon, Y; Peleg, H; Greenfeld, Z; Rosen, S; Brezis, M

    1994-01-01

    Human radiocontrast nephrotoxicity is predicted by the presence of multiple risk factors, often associated with compromised renal circulation. To produce a simple model of radiocontrast nephropathy, rats were pretreated with indomethacin and N omega-nitro-L-arginine methyl ester (L-NAME, to inhibit nitric oxide synthesis) before the administration of iothalamate. Acute renal failure consistently developed, with a decline in creatinine clearance from 1.05 +/- 0.10 to 0.27 +/- 0.05 ml/min (P < ...

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

    Directory of Open Access Journals (Sweden)

    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.

  12. Type I second-degree AV block after neostigmine administration in a child with renal failure.

    OpenAIRE

    Webb, M. D.

    1995-01-01

    Neostigmine is commonly used to reverse neuromuscular blockade. A side effect can be parasympathetic stimulation, which may result in heart block. Renal failure can decrease the clearance and increase the half-life of the drug, thus increasing the likelihood of a vagomimetic response. A case is presented where a child with renal failure developed a type I second-degree heart block after neostigmine was given.

  13. Pharmacokinetics of flupirtine in elderly volunteers and in patients with moderate renal impairment.

    OpenAIRE

    Abrams, S. M.; Baker, L R; Crome, P; White, A S; Johnston, A; Ankier, S. I.; Warrington, S. J.; Turner, P.; Niebch, G.

    1988-01-01

    The pharmacokinetics of flupirtine after a single oral dose of 100mg have been studied in patients with moderate renal impairment and in healthy elderly subjects aged 66-83 years. Mean elimination half-life of flupirtine was higher in elderly patients than in younger normal subjects, and this was associated with an increased maximum serum concentration and reduced clearance. The mean half-life in patients with renal impairment was higher than in normal subjects. There was no correlation betwe...

  14. Comparison of bone and renal effects in HIV-infected adults switching to abacavir or tenofovir based therapy in a randomized trial

    DEFF Research Database (Denmark)

    Rasmussen, Thomas A; Jensen, Danny; Tolstrup, Martin;

    2012-01-01

    ), and osteoprotegerin). We assessed renal function by estimated creatinine clearance, plasma cystatin C, and urinary levels of creatinine, albumin, cystatin C, and neutrophil gelatinase-associated lipocalin (NGAL). The changes from baseline in BMD and renal and bone biomarkers were compared across study arms. Results...

  15. Pharmacokinetics of netivudine, a potent anti-varicella zoster virus drug, in patients with renal impairment.

    Science.gov (United States)

    Fillastre, J P; Godin, M; Legallicier, B; Chretien, P; Bidault, R; Gillotin, C; Wooton, R; Posner, J; Peck, R W

    1996-05-01

    The pharmacokinetics of a single oral 200 mg dose of netivudine (1-(beta-D-arabinofuranosyl)-5-(1-propynyl)uracil), a nucleoside analogue under development for use in varicella zoster virus infections, were studied in 12 renal failure (RF) subjects (creatinine clearance 15 +/- 7 mL/min) and 12 age-matched healthy subjects with normal creatinine clearance. Blood and urine samples were collected up to nine days after drug administration. Concentrations of netivudine and of its main metabolite, the pyrimidine base 5-(1-propynyl)uracil (5 PU), were determined by a specific high performance liquid chromatography assay. The mean peak plasma concentrations of netivudine, Tmax, and volume of distribution were not significantly affected by RF. The elimination half-life of netivudine was approximately 15 h in subjects with normal renal function and 60 h in RF patients. Plasma and renal clearances of netivudine were significantly reduced in RF patients and AUC was three to four times higher in these patients. Cmax and AUC of 5 PU were higher in RF patients, and the half-life was also significantly longer. However, the half-life of this metabolite was much lower than that of the parent compound. Tmax and the lag time were similar in the two groups. There were highly significant correlations for netivudine and 5 PU between half-life and creatinine clearance and between renal clearance and creatinine clearance. These findings suggest that netivudine dosage may need to be reduced in patients with severe renal failure, and confirm that formation of the 5 PU is independent of the elimination of netivudine from plasma.

  16. Clearance of beta-2-microglobulin and middle molecules in haemodiafiltration.

    Science.gov (United States)

    Tattersall, James

    2007-01-01

    Middle molecules, consisting mostly of peptides and small proteins with molecular weight the range of 500-60,000 Da, accumulate in renal failure and contribute to the uraemic toxic state. Beta2-microglobulin (beta2-MG) with a molecular weight of 11,000 is considered representative of these middle molecules. These solutes are not well cleared by low-flux dialysis. High-flux dialysis will clear middle molecules, partly by internal filtration. This convective component of high-flux dialysis can be enhanced in a predictable way by haemodiafiltration (HDF). The convective and diffusive clearance rates of any middle molecule across any haemodiafilter can be predicted from known or measurable factors such as its sieving coefficient, bound fraction and molecular weight. The removal of middle molecules is also influenced by factors within the patient. Beta2-MG is distributed within the extracellular fluid. During HDF, beta2-MG must transfer into the intravascular compartment across the capillary walls. This transcapillary transfer at a rate of approximately 100 ml/min slows beta2-MG removal from the body. Continuing transfer after the end of a treatment session results in a significant rebound of beta2-MG levels. This intercompartment transfer and its effect on beta2-MG clearance and concentration can be predicted by a 2-compartment model. By extrapolation, the behaviour of other middle molecules can be predicted. The 2-compartment model, which takes non-dialytic beta2-MG clearance at a rate of 3 ml/min and beta2-MG generation at a rate of 0.1 mg/min into account, can predict the effect of any HDF schedule on beta2-MG levels. Low-flux dialysis results in a beta2-MG level of around 40 mg/l. Three times weekly, 4-hour HDF can reduce beta2-MG levels to around 20 mg/l. Long (nocturnal) HDF can reduce beta2-MG levels to around 10 mg/l, compared to physiological levels of less than 5 mg/l.

  17. Effects of renal failure on drug transport and metabolism.

    Science.gov (United States)

    Sun, Hong; Frassetto, Lynda; Benet, Leslie Z

    2006-01-01

    Renal failure not only alters the renal elimination, but also the non-renal disposition of drugs that are extensively metabolized by the liver. Although reduced metabolic enzyme activity in some cases can be responsible for the reduced drug clearance, alterations in the transporter systems may also be involved in the process. With the development of renal failure, the renal secretion of organic ions mediated by organic anion transporters (OATs) and organic cation transporters (OCTs) is decreased. 3-Carboxy-4-methyl-5-propyl-2-furanpropanoic acid (CMPF) and other organic anionic uremic toxins may directly inhibit the renal excretion of various drugs and endogenous organic acids by competitively inhibiting OATs. In addition, the expression of OAT1 and OCT2 was reduced in chronic renal failure (CRF) rats. Renal failure also impairs the liver uptake of drugs and organic anions, such as bromosulphophthalein (BSP), indocyanine green (ICG), and thyroxine, where organic anion transport polypeptides (OATPs) are the major transporters. Most previous studies have been done in animals or cell culture, very often in rat models, but these are presumed to reflect the presentation of advanced renal disease in humans as well. Recent studies demonstrate that the uremic toxins CMPF and indoxyl sulfate (IS) can directly inhibit rOatp2 and hOATP-C in hepatocytes. The protein content of the liver uptake transporters Oatp1, 2, and 4 were significantly decreased in CRF rats. Decreased activity of the intestinal efflux transporter, P-glycoprotein (P-gp), was also observed in CRF rats, with no significant change of protein content, suggesting that uremic toxins may suppress P-gp function. However, increased protein levels of multidrug resistance-associated protein (MRP) 2 in the kidney and MRP3 in the liver were found in CRF rats, suggesting an adaptive response that may serve as a protective mechanism. Increases in drug areas under the curve (AUCs) in subjects with advanced renal disease

  18. Rhabdomyolysis and unilateral renal infarction after a motor vehicle crash.

    Science.gov (United States)

    Sanai, Toru; Yokoyama, Masaaki; Murata, Akinari; Ukon, Kei; Fuchigami, Kazumi

    2007-01-01

    A 46-year-old man with no previous history of abnormal urinalysis findings or renal dysfunction was admitted to a local hospital because of a motor vehicle crash. An open laparotomy was performed to treat a perforation of the small intestine. After operation, oliguria and renal dysfunction developed, and he was admitted to our hospital because of acute renal failure after trauma. Acute renal failure was assumed to be due to rhabdomyolysis with elevated serum creatinine, blood urea nitrogen, and creatine kinase levels and myoglobinemia. Left flank pain occurred several days after admission, and the serum alkaline phosphatase level increased between days 5 and 12 following admission. Although hemodialysis was performed 9 times and the urine output was satisfactory, the creatinine clearance levels increased only to about 50 mL/min/1.73 m2 (0.84 mL/s/m2) at 6 weeks following admission. As a result, a diagnosis of renal infarction due to acute renal artery occlusion was considered. The left kidney was atrophic on an abdominal computed tomographic scan and was nonfunctioning on a renogram. This case shows the importance of not overlooking the possibility of a renal infarction associated with rhabdomyolysis after a motor vehicle crash. In particular, the changes in the serum alkaline phosphatase levels were important in making a correct diagnosis in this case.

  19. Pitfalls and Limitations of Radionuclide Renal Imaging in Adults.

    Science.gov (United States)

    Keramida, Georgia; James, Jacqueline M; Prescott, Mary C; Peters, Adrien Michael

    2015-09-01

    To understand pitfalls and limitations in adult renography, it is necessary to understand firstly the physiology of the kidney, especially the magnitude and control of renal blood flow, glomerular filtration rate and tubular fluid flow rate, and secondly the pharmacokinetics and renal handling of the three most often used tracers, Tc-99m-mercaptoacetyltriglycine (MAG3), Tc-99m-diethylene triamine pentaacetic acid (DTPA) and Tc-99m-dimercaptosuccinic acid (DMSA). The kidneys may be imaged dynamically with Tc-99m-MAG3 or Tc-99m-DTPA, with or without diuretic challenge, or by static imaging with Tc-99m-DMSA. Protocols are different according to whether the kidney is native or transplanted. Quantitative analysis of dynamic data includes measurement of renal vascularity (important for the transplanted kidney), absolute tracer clearance rates, differential renal function (DRF) and response to diuretic challenge. Static image reveals functional renal parenchymal damage, both focal and global, is useful in the clinical management of obstructive uropathy, renal stone disease and hypertension (under angiotensin converting enzyme inhibition), and is the preferred technique for determining DRF. Diagnosis based on morphological appearances is important in transplant management. Even though nuclear medicine is now in the era of hybrid imaging, renal imaging remains an important subspecialty in nuclear medicine and requires a sound basing in applied physiology, the classical supporting discipline of nuclear medicine.

  20. Clinical nuclear medicine applications in Turkey and specific renal studies

    International Nuclear Information System (INIS)

    Full text: Nuclear cardiology, nuclear oncology, pediatric nuclear medicine and nuclear endocrinology are the main application areas of clinical nuclear medicine in Turkey. Not only imaging studies, but also therapeutic application of radiopharmaceuticals is also performed at many institutes, such as hyperthyroidism treatment with radioiodine, thyroid cancer ablation and metastases treatment with radioiodine, radio synovectomy, metastatic pain therapy, and recently radioimmunotherapy of lymphomas. Almost all radionuclides and radiopharmaceuticals are obtained commercially from European countries, except 18-FDG which is obtained from two cyclotrons in Turkey. More than 30.000 renal procedures are performed at the University hospitals in a year. Pediatric age groups is approximately % 55 of patients. 99mTc-DTPA (%44), 99mTc-DMSA (%37), 99mTc-MAG3 (%17) and 99mTc-EC (%2) are the most commonly used radiopharmaceuticals for renal imaging. More than 6.000 vials of several pharmaceuticals are used for renal cortical scintigraphy (%35), dynamic renal imaging (%34), renal scintigraphy with diuretic (%27) and captopril scintigraphy (%4). Most common indication for renal cortical scintigraphy is detection of cortical scarring (%53). In addition, using single plasma sample method or gamma-camera method renal clearance measurements with 99mTc-MAG3 99mTc-DTPA have been used at some institutions

  1. Pharmacologic agents for mucus clearance in bronchiectasis.

    Science.gov (United States)

    Nair, Girish B; Ilowite, Jonathan S

    2012-06-01

    There are no approved pharmacologic agents to enhance mucus clearance in non-cystic fibrosis (CF) bronchiectasis. Evidence supports the use of hyperosmolar agents in CF, and studies with inhaled mannitol and hypertonic saline are ongoing in bronchiectasis. N-acetylcysteine may act more as an antioxidant than a mucolytic in other lung diseases. Dornase α is beneficial to patients with CF, but is not useful in patients with non-CF bronchiectasis. Mucokinetic agents such as β-agonists have the potential to improve mucociliary clearance in normals and many disease states, but have not been adequately studied in patients with bronchiectasis.

  2. Pharmacologic agents for mucus clearance in bronchiectasis.

    Science.gov (United States)

    Nair, Girish B; Ilowite, Jonathan S

    2012-06-01

    There are no approved pharmacologic agents to enhance mucus clearance in non-cystic fibrosis (CF) bronchiectasis. Evidence supports the use of hyperosmolar agents in CF, and studies with inhaled mannitol and hypertonic saline are ongoing in bronchiectasis. N-acetylcysteine may act more as an antioxidant than a mucolytic in other lung diseases. Dornase α is beneficial to patients with CF, but is not useful in patients with non-CF bronchiectasis. Mucokinetic agents such as β-agonists have the potential to improve mucociliary clearance in normals and many disease states, but have not been adequately studied in patients with bronchiectasis. PMID:22640851

  3. Effects of a long-acting formulation of octreotide on renal function and renal sodium handling in cirrhotic patients with portal hypertension: a randomized, double-blind, controlled trial

    DEFF Research Database (Denmark)

    Ottesen, LH; Aagaard, N K; Kiszka-Kanowitz, M;

    2001-01-01

    . The patients were in sodium steady state at the time of study. Glomerular filtration rate (GFR) and effective renal plasma flow (ERPF) were measured by a constant infusion clearance technique. Renal sodium handling was determined by lithium and sodium clearance measurements. Therapeutic serum levels...... during octreotide treatment were not significantly different from those of placebo. In addition, no changes in free water clearance, urinary flow rate, or 24-hour Na excretion were demonstrated. A significant increase of mean arterial pressure (+5 mm Hg; P ... of octreotide along with a reduction of insulin-like growth factor I (IGF-I) (P filtration fraction (GFR/ERPF). Changes in clearance and extraction fraction of sodium and lithium...

  4. Effect of chronic accumulation of aluminum on renal function, cortical renal oxidative stress and cortical renal organic anion transport in rats.

    Science.gov (United States)

    Mahieu, Stella T; Gionotti, Marisa; Millen, Néstor; Elías, María Mónica

    2003-11-01

    The aim of the present work was to study the nephrotoxicity of aluminum lactate administered for 3 months (0.57 mg/100 g bodyweight aluminum, i.p., three times per week) to male Wistar rats. Renal function was studied after 6 weeks of treatment (urine was obtained from rats in metabolic cages) and at the end of the treatment using clearance techniques. Another group of rats was used as kidneys donors at the end of treatment. The renal cortex was separated and homogenized to determine glutathione (GSH) level, glutathione S-transferase (GST) activity and lipid peroxidation (LPO) level. Renal cortex slices were also used to study the p-aminohippuric acid (PAH) accumulation during steady-state conditions and the kinetics of uptake process. Clearance results, at the end of the treatment, indicated that renal functions in treated-rats were not different from those measured in control rats, although the renal concentration parameters differ when they were measured in treated rats after 24 h of food and water deprivation. Balances of water and sodium were also modified at both 1.5 and 3 months of treatment. The activity of alkaline phosphatase (AP) relative to inulin excreted in urine was significantly impaired: controls 2.2+/-0.6 IUI/mg, Al-treated 5.1+/-0.5 IU/mg, Prats. Renal accumulation of PAH, estimated as slice-to-medium ratio, decreased significantly in the Al-treated rats: control rats 3.06+/-0.02 ( n=12), Al-treated rats 2.26+/-0.04 ( n=12), Prats, while the apparent affinity remained unchanged. All these results indicate that aluminum accumulation in renal tissue affects cellular metabolism, promotes oxidative stress and induces alterations in renal tubular PAH transport, together with an impairment in sodium and water balance only detected under conditions of water deprivation, without other evident changes in glomerular filtration rate or other global functions measured by clearance techniques at least at this time of chronic toxicity.

  5. Renal (Kidney) Manifestations in TSC

    Medline Plus

    Full Text Available ... renal (kidney) disease during their lifetime. There are three particular renal disorders in TSC: renal cysts, renal ... at the time of diagnosis, and at 2-3 year intervals if no cysts or angiomyolipomas are ...

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

    Institute of Scientific and Technical Information of China (English)

    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.

  7. Renal papillary necrosis

    Science.gov (United States)

    ... your provider. Alternative Names Necrosis - renal papillae; Renal medullary necrosis Images Kidney anatomy Kidney - blood and urine flow References Ruggenenti P, Cravedi P, Remuzzi G. Microvascular and macrovascular diseases of the kidney. In: Taal MW, Chertow GM, ...

  8. Kidney (Renal) Failure

    Science.gov (United States)

    ... How is kidney failure treated? What is kidney (renal) failure? The kidneys are designed to maintain proper fluid ... marrow and strengthen the bones. The term kidney (renal) failure describes a situation in which the kidneys have ...

  9. Renal arteries (image)

    Science.gov (United States)

    A renal angiogram is a test used to examine the blood vessels of the kidneys. The test is performed ... main vessel of the pelvis, up to the renal artery that leads into the kidney. Contrast medium ...

  10. Cardio Renal Syndrome

    Directory of Open Access Journals (Sweden)

    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.

  11. Uptake and clearance of uranium by misgurnus

    International Nuclear Information System (INIS)

    The author studied the bioconcentration and clearance of uranium in misgurnus and determined bioconcentration factors (BCF) as well as uptake and depuration rate constants. The test was performed under semi-static conditions. The depuration of uranium was best described by a two-compartment first order kinetic model

  12. 32 CFR 154.16 - Security clearance.

    Science.gov (United States)

    2010-07-01

    ... requirements for clearance—(1) Top Secret. (i) Final Clearance: (A) BI. (B) Established billet per § 154.13(e... initiated (D) Favorable review of local personnel, base/military police, medical, and other security records...) Provisions of paragraph § 154.14(e) (1) and (2) have been met regarding civilian personnel. (2) Secret....

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

    DEFF Research Database (Denmark)

    Wolff, Jesper; Bigler, Dennis Richard; Christensen, C B;

    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 fr...

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

    DEFF Research Database (Denmark)

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

    1996-01-01

    in either treatment regimen was associated with a long-term slower progression of renal failure. Over 9 months, the 24-hour fractional clearance of albumin decreased in the ACE inhibitor group (P retinol-binding protein were unchanged in this group...

  15. On Renal Artery Stenosis

    OpenAIRE

    Eklöf, Hampus

    2005-01-01

    Renal artery stenosis (RAS) is a potentially curable cause of hypertension and azotemia. Besides intra-arterial renal angiography there are several non-invasive techniques utilized to diagnose patients with suspicion of renal artery stenosis. Removing the stenosis by revascularization to restore unobstructed blood flow to the kidney is known to improve and even cure hypertension/azotemia, but is associated with a significant complication rate. To visualize renal arteries with x-ray technique...

  16. [Renal osteodystrophy (2): its treatment in renal insufficiency before dialysis].

    Science.gov (United States)

    Hottelart, C; Bako, G; Oprisiu, R; Georgita, A; Presne, C; Sarraj, A; Morinière, P; el Esper, N; Fournier, A

    2000-01-01

    1. In the patient with renal insufficiency before dialysis, the phosphocalcic disorders appear insidiously. They are dominated by hyperparathyroidism which will be diagnosed on the initially yearly determination of plasma intact PTH as soon as creatinine clearance decreases below 60 ml/min, eventhough there is still no modification in plasma concentrations of calcium and phosphate. Its diagnosis should lead to initiate the therapeutic measures in order to prevent the irreversible thining of the corticals by endosteal resorption and later the occurrence of histological and radiological osteitis fibrosa favoring fractures. 2. Hyperparathyroidism prevention relies on two main measures: prevention of phosphate retention and hypocalcemia is implemented by progressive phosphate and protein restriction (from 1 g/kg/day when Ccr vitamin D repeletion will be implemented by systematic supplementation of native vitamin D or 25OH vitamin D3 in order to bring P25OHD between 30-60 ng/ml (75-150 nmol/l) or more generally around the upper limit of the epidemiologic range of the laboratory; these measures should aim at maintaining plasma intact PTH in its optimal range variable with the degree of renal insufficiency: 0.5-1; 1-2.5 and 2-3 folds the upper limit of normal for creatinine clearance respectively at 60-30; 30-10 and vitamin D derivatives will be regularly efficient and safe only when non-calcemic non-aluminic phosphate binder will be available and proven to be without side-effects. 4. Instrumental (surgical or by alcohol injection) parathyroidectomy should be considered when plasma intact PTH is > 5 to 7 times the upper limit of normal in the presence of hypercalcemia (> 2.60 mmol/l) and/or hyperphosphatemia (> 1.70 nmol/l) in spite of the above measures, the decision being reinforced by coexistence of bone radiologic abnormalities and metastatic calcifications. 5. Adynamic bone diseases are rare before hemodialysis in the absence of aluminum exposition by the drinking

  17. Caracterización de la función renal en perros

    OpenAIRE

    Pedro Pablo Martínez Padua

    2012-01-01

    Mediante filtración, reabsorción y excreción, los riñones mantienen la homeostasis en los organismos vivos. Los perros con lesiones renales tienen afectados estos procesos, que alteran la homeostasis. Ello da como resultado cuadros de insuficiencia renal. Se evaluaron parámetros que estiman la filtración, reabsorción y excreción renal en tres grupos de perros, referentes a concentración sérica de creatinina, relación proteína-creatinina urinaria, clearance de creatinina, excreción fraccionada...

  18. Renal AA amyloidosis in a patient with hereditary complete complement C4 deficiency

    Directory of Open Access Journals (Sweden)

    Imed Helal

    2011-01-01

    Full Text Available Hereditary complete C4 deficiency has until now been reported in 30 cases only. A disturbed clearance of immune- complexes probably predisposes these individuals to systemic lupus erythematosus, other immune- complex diseases and recurrent microbial infections. We present here a 20- year- old female with hereditary complete C4 deficiency. Renal biopsy demonstrated renal AA amyloidosis. This unique case further substantiates that deficiency of classical pathway components predisposes to the development of recurrent microbial infections and that the patients may develop AA amyloidosis. Furthermore, in clinical practice, the nephrotic syndrome occurring in a patient with hereditary complete complement C4 deficiency should lead to the suspicion of renal AA amyloidosis.

  19. Renal inflammatory myofibroblastic tumor

    DEFF Research Database (Denmark)

    Heerwagen, S T; Jensen, C; Bagi, P;

    2007-01-01

    Renal inflammatory myofibroblastic tumor (IMT) is a rare soft-tissue tumor of controversial etiology with a potential for local recurrence after incomplete surgical resection. The radiological findings in renal IMT are not well described. We report two cases in adults with a renal mass treated...

  20. Recurrent acute renal failure

    OpenAIRE

    Satish, S.; Rajesh, R.; Kurian, G.; Seethalekshmi, N. V.; Unni, M.; Unni, V. N.

    2010-01-01

    While acute renal failure secondary to intravascular hemolysis is well described in hemolytic anemias, recurrent acute renal failure as the presenting manifestation of a hemolytic anemia is rare. We report a patient with recurrent acute renal failure who was found to have paroxysmal nocturnal hemoglobinuria (PNH), on evaluation.

  1. Aspects of osseous, peritoneal and renal handling of bisphosphonate during peritoneal dialysis: a methodological study

    DEFF Research Database (Denmark)

    Joffe, P; Henriksen, Jens Henrik Sahl

    1996-01-01

    to continuous ambulatory peritoneal dialysis (CAPD). The aims were: to assess the kinetics of 99m-technetium MBP (99mTc-MBP) in CAPD, and to evaluate the correctness of the assumption that the peritoneal and renal clearances of 99mTc-MBP equal the total plasma clearance of 51-chromium ethylenediamine tetra......-acetic acid (51Cr-EDTA). Eight patients on CAPD were studied cross-sectionally. The mean plasma clearances of 99mTc-MBP and 51Cr-EDTA in the steady state (4h) were 38.2 and 12.2 ml min-1 (p peritoneal clearances (0-4 h) were 5.2 and 7.2 ml min-1 (p ....5 and 2.8 ml min-1 (not significant), respectively. The bone bisphosphonate clearance (BBC) at steady state was 26.0 ml min-1, a value which was significantly higher than that at infinity (16.5 ml min-1, p peritoneal and renal clearances of 99m...

  2. Dynamics modeling and simulation of mechanism with joint clearance

    Institute of Scientific and Technical Information of China (English)

    BAI Zheng-feng; TIAN Hao; ZHAO Yang

    2010-01-01

    The existence of clearance in the joints of mechanisms system is inevitable.The movements of the real mechanism are deftection from the ideal mechanism due to the clearances and the motion accuracv is decreased.The effects of the hinge clearance on the crank and rocker mechanism system are studied.The svstem dynamics equation with clearance is presented.The contact dynamics model is established using the nonlinear equivalent spring-damp model and the friction effect is considered by using Coulomb friction model.Then the models are incorporated into ADAMS,and based on the model,large numbers numeric simulations are made.The regularity of contact forces in clearance are studied in detail.And the effects of clearance size.clearance friction on the mechanism dynamics characteristic are analyzed.The simulation resuhs Can predict the effects of clearance on the mechanism dynamics characteristic preferably.

  3. 19 CFR 122.26 - Entry and clearance.

    Science.gov (United States)

    2010-04-01

    ... AIR COMMERCE REGULATIONS Private Aircraft § 122.26 Entry and clearance. Private aircraft, as defined... information as set forth in § 122.22(c), and grants electronic clearance via electronic mail or telephone....

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

    Institute of Scientific and Technical Information of China (English)

    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.

  5. Absolute 24 h quantification of 99Tcm-DMSA uptake in patients with severely reduced kidney function: a comparison with 51Cr-EDTA clearance.

    Science.gov (United States)

    van de Wiele, C; van den Eeckhaut, A; Verweire, W; van Haelst, J P; Versijpt, J; Dierckx, R A

    1999-09-01

    The aim of this study was to determine whether absolute 24 h DMSA uptake measurements (%DMSA) correlate well with 51Cr-EDTA clearance measurements in patients with severely reduced kidney function (SRKF). Between 1990 and 1997, 55 of 482 patients who underwent EDTA clearance measurements also underwent %DMSA within 1 week. Of these, 31 were women and 24 were men (mean age 60 years; range 19-77 years). EDTA clearance was determined using the slope-intercept method. Absolute depth- and background-corrected %DMSA were determined 24 h following the injection of 185 MBq per 1.73 m2 freshly prepared 99Tcm-DMSA. All patients had EDTA clearance 20 ml.min-1 (mean +/- S.D. = 30.9 +/- 13.8 ml.min-1), whereas 37 patients (group B: 22 women and 15 men, mean age 62.0 years, range 19-77 years) had EDTA clearance DMSA for the patients as a whole and for group A (r = 0.87, P = 0.73; r = 0.79, P = 0.0001 respectively). The regression equation suggests that %DMSA is not a marker of early renal dysfunction. In group B, the r-value (r = 0.48, P = 0.004) suggests that %DMSA is reliable as a marker of severe renal dysfunction to the extent that it provides rough information. In conclusion, %DMSA may not be used as a marker of early renal impairment. Additionally, in patients with severely reduced kidney function (EDTA clearance < 20 ml.min-1), it only provides a rough estimate.

  6. Renal Function Assessment During Peptide Receptor Radionuclide Therapy.

    Science.gov (United States)

    Erbas, Belkis; Tuncel, Murat

    2016-09-01

    Theranostics labeled with Y-90 or Lu-177 are highly efficient therapeutic approaches for the systemic treatment of various cancers including neuroendocrine tumors and prostate cancer. Peptide receptor radionuclide therapy (PRRT) has been used for many years for metastatic or inoperable neuroendocrine tumors. However, renal and hematopoietic toxicities are the major limitations for this therapeutic approach. Kidneys have been considered as the "critical organ" because of the predominant glomerular filtration, tubular reabsorption by the proximal tubules, and interstitial retention of the tracers. Severe nephrotoxity, which has been classified as grade 4-5 based on the "Common Terminology Criteria on Adverse Events," was reported in the range from 0%-14%. There are several risk factors for renal toxicity; patient-related risk factors include older age, preexisting renal disease, hypertension, diabetes mellitus, previous nephrotoxic chemotherapy, metastatic lesions close to renal parenchyma, and single kidney. There are also treatment-related issues, such as choice of radionuclide, cumulative radiation dose to kidneys, renal radiation dose per cycle, activity administered, number of cycles, and time interval between cycles. In the literature, nephrotoxicity caused by PRRT was documented using different criteria and renal function tests, from serum creatinine level to more accurate and sophisticated methods. Generally, serum creatinine level was used as a measure of kidney function. Glomerular filtration rate (GFR) estimation based on serum creatinine was preferred by several authors. Most commonly used formulas for estimation of GFR are "Modifications of Diet in Renal Disease" (MDRD) equation and "Cockcroft-Gault" formulas. However, more precise methods than creatinine or creatinine clearance are recommended to assess renal function, such as GFR measurements using Tc-99m-diethylenetriaminepentaacetic acid (DTPA), Cr-51-ethylenediaminetetraacetic acid (EDTA), or

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

    Science.gov (United States)

    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

  8. Diminished creatinine clearance in anorexia nervosa: reversal with weight gain.

    OpenAIRE

    Boag, F.; Weerakoon, J; Ginsburg, J; Havard, C W; Dandona, P

    1985-01-01

    To assess whether patients with anorexia nervosa have abnormalities in creatinine clearance, we measured plasma creatinine concentration, urinary creatinine excretion, and creatinine clearance in 10 patients with anorexia nervosa before and during treatment. Urinary creatinine excretion and creatinine clearance were diminished in all patients. Nine patients had significant decreases in their plasma creatinine and creatinine clearance was increased even when corrected for body weight and body ...

  9. BILATERAL DUPLICATION OF RENAL ARTERIES

    Directory of Open Access Journals (Sweden)

    Prajkta A Thete

    2014-09-01

    Full Text Available Routine dissection of a male cadaver revealed the presence of bilateral double renal arteries. On the right side the accessory renal artery originated from the abdominal aorta just above the main renal artery. On the left side the accessory renal artery originated from the abdominal aorta about 1 cm above the main renal artery. Knowledge of the variations of renal vascular anatomy has importance in exploration and treatment of renal trauma, renal transplantation, renal artery embolization, surgery for abdominal aortic aneurysm and conservative or radical renal surgery

  10. Anemia in pediatric renal transplant recipients.

    Science.gov (United States)

    Kausman, Joshua Yehuda; Powell, Harley Robert; Jones, Colin Lindsay

    2004-05-01

    The aim of this study was to establish the prevalence of anemia in stable pediatric renal transplant recipients and to examine the association of anemia with renal function, immunosuppressants, angiotensin converting enzyme inhibitors, and growth, as well as iron, vitamin B(12), and folate stores. This is a cross-sectional study of the 50 renal transplant recipients currently followed at our center. Patient data were collected regarding hematological parameters, growth, medications, renal function, underlying renal disease, delayed graft function, episodes of rejection, and iron or erythropoietin therapy post transplantation. The mean hemoglobin level (Hb) was 110 g/l and the overall prevalence of anemia was 60%, including 30% who were severely anemic (Hb<100 g/l). There was a high rate of iron deficiency (34%) and serum iron was the parameter of iron metabolism most closely associated with anemia. Hb in patients with low serum iron was 90.7 g/l versus 114.4 g/l in those with normal serum iron ( P<0.01). Both univariate and multiple linear regression determined tacrolimus dose and creatinine clearance to be significant factors associated with anemia. Tacrolimus dose correlated with a 10 g/l reduction in Hb for every increase of tacrolimus dose of 0.054 mg/kg per day ( P=0.001). The dose of mycophenolate was positively correlated with Hb, but this was likely to be confounded by our practice of dose reduction in the setting of anemia. Angiotensin converting enzyme inhibitor use was not associated with anemia. Severely anemic patients tended to be shorter, with a mean Z-score for height of -1.8 compared with -0.9 for those with normal Hb ( P=0.02). Anemia is a significant and common problem in pediatric renal transplant patients. Deteriorating renal function is an important cause, but other factors like iron deficiency and immunosuppression are involved. Definition of iron deficiency is difficult and serum iron may be a valuable indicator. Medication doses

  11. Renal infarction resulting from traumatic renal artery dissection.

    Science.gov (United States)

    Kang, Kyung Pyo; Lee, Sik; Kim, Won; Jin, Gong Yong; Na, Ki Ryang; Yun, Il Yong; Park, Sung Kwang

    2008-06-01

    Renal artery dissection may be caused by iatrogenic injury, trauma, underlying arterial diseases such as fibromuscular disease, atherosclerotic disease, or connective tissue disease. Radiological imaging may be helpful in detecting renal artery pathology, such as renal artery dissection. For patients with acute, isolated renal artery dissection, surgical treatment, endovascular management, or medical treatment have been considered effective measures to preserve renal function. We report a case of renal infarction that came about as a consequence of renal artery dissection.

  12. [Hypertension and renal disease

    DEFF Research Database (Denmark)

    Kamper, A.L.; Pedersen, E.B.; Strandgaard, S.

    2009-01-01

    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...... 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...

  13. Postpartum renal vein thrombosis.

    Science.gov (United States)

    Rubens, D; Sterns, R H; Segal, A J

    1985-01-01

    Renal vein thrombosis in adults is usually a complication of the nephrotic syndrome. Rarely, it has been reported in nonnephrotic women postpartum. The thrombosis may be a complication of the hypercoagulable state associated with both the nephrotic syndrome and pregnancy. Two postpartum patients with renal vein thrombosis and no prior history of renal disease are reported here. Neither patient had heavy proteinuria. In both cases, pyelonephritis was suspected clinically and the diagnosis of renal vein thrombosis was first suggested and confirmed by radiologic examination. Renal vein thrombosis should be considered in women presenting postpartum with flank pain.

  14. Wear analysis of revolute joints with clearance in multibody systems

    Science.gov (United States)

    Bai, ZhengFeng; Zhao, Yang; Wang, XingGui

    2013-08-01

    In this work, the prediction of wear for revolute joint with clearance in multibody systems is investigated using a computational methodology. The contact model in clearance joint is established using a new hybrid nonlinear contact force model and the friction effect is considered by using a modified Coulomb friction model. The dynamics model of multibody system with clearance is established using dynamic segmentation modeling method and the computational process for wear analysis of clearance joint in multibody systems is presented. The main computational process for wear analysis of clearance joint includes two steps, which are dynamics analysis and wear analysis. The dynamics simulation of multibody system with revolute clearance joint is carried out and the contact forces are drawn and used to calculate the wear amount of revolute clearance joint based on the Archard's wear model. Finally, a four-bar multibody mechanical system with revolute clearance joint is used as numerical example application to perform the simulation and show the dynamics responses and wear characteristics of multibody systems with revolute clearance joint. The main results of this work indicate that the contact between the joint elements is wider and more frequent in some specific regions and the wear phenomenon is not regular around the joint surface, which causes the clearance size increase non-regularly after clearance joint wear. This work presents an effective method to predict wear of revolute joint with clearance in multibody systems.

  15. 10 CFR 706.31 - Clearance of conciliators and arbitrators.

    Science.gov (United States)

    2010-01-01

    ... 10 Energy 4 2010-01-01 2010-01-01 false Clearance of conciliators and arbitrators. 706.31 Section... RELATIONS Contract Negotiation and Administration § 706.31 Clearance of conciliators and arbitrators. Conciliators and arbitrators who are regularly assigned to DOE cases may be processed for “Q” clearance at...

  16. Guangzhou Customs Guide to Clearance of Import/Export Goods

    Institute of Scientific and Technical Information of China (English)

    2009-01-01

    @@ Management of the Enterprises Granted for Convenient and Quick Customs Clearance 1.What is the enterprise granted for convenient and quick customs clearance? Customs General Administration and the Ministry of Foreign Trade and Economic Cooperation jointly issued policy measures to facilitate customs clearance in 2001 to further support the development of hightech industries.The enterprise .

  17. 14 CFR 1260.63 - Customs clearance and visas.

    Science.gov (United States)

    2010-01-01

    ... 14 Aeronautics and Space 5 2010-01-01 2010-01-01 false Customs clearance and visas. 1260.63 Section 1260.63 Aeronautics and Space NATIONAL AERONAUTICS AND SPACE ADMINISTRATION GRANTS AND COOPERATIVE AGREEMENTS General Special Conditions § 1260.63 Customs clearance and visas. Customs Clearance and Visas...

  18. 14 CFR 27.661 - Rotor blade clearance.

    Science.gov (United States)

    2010-01-01

    ... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Rotor blade clearance. 27.661 Section 27... AIRWORTHINESS STANDARDS: NORMAL CATEGORY ROTORCRAFT Design and Construction Rotors § 27.661 Rotor blade clearance. There must be enough clearance between the rotor blades and other parts of the structure...

  19. 14 CFR 29.661 - Rotor blade clearance.

    Science.gov (United States)

    2010-01-01

    ... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Rotor blade clearance. 29.661 Section 29... AIRWORTHINESS STANDARDS: TRANSPORT CATEGORY ROTORCRAFT Design and Construction Rotors § 29.661 Rotor blade clearance. There must be enough clearance between the rotor blades and other parts of the structure...

  20. 32 CFR 644.517 - Clearance of Army lands.

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 4 2010-07-01 2010-07-01 true Clearance of Army lands. 644.517 Section 644.517 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY (CONTINUED) REAL PROPERTY REAL... and Improvements § 644.517 Clearance of Army lands. The responsibility for performing clearance...

  1. Impact of mild renal impairment on early postoperative mortality after open cardiac surgery

    Directory of Open Access Journals (Sweden)

    Ghani A

    2010-01-01

    Full Text Available Preoperative severe renal impairment is included in the risk scores to predict out-come after open cardiac surgery. The purpose of this study was to assess the impact of pre-operative mild renal impairment on the early postoperative mortality after open heart surgery. Data of all cases of open cardiac surgery performed from January 2005 to June 2006 were collec-ted. Cases with preoperative creatinine clearance below 60 mL/min were excluded from the study. Data were retrospectively analyzed to find the impact of renal impairment on short-term outcome. Of the 500 cases studied, 47 had preoperative creatinine clearance between 89-60 mL/min. The overall mortality in the study cases was 6.8%. The mortality was 28.7% in those who developed postoperative ARF, 33.3% in those who required dialysis and 40.8% in those with preoperative mild renal impairment. Binary logistic regression analysis showed that female gender (P = 0.01, preoperative mild renal impairment (P = 0.007 as well as occurrence of multi organ failure (P < 0.001 were the only independent variables determining the early postoperative mortality after cardiac surgeries. Among them, preoperative mild renal impairment was the most significant and the best predictor for early postoperative mortality after cardiac surgery. Our study suggests that renal impairment remains a strong predictor of early mortality even after adjustment for several confounders.

  2. The effect of prostaglandin E1 on recovery of early renal graft functions after transplantation

    Institute of Scientific and Technical Information of China (English)

    Song Huanjin; Xue Wujun; Tian Xiaohui; Li Yang; Ding Chenguang; Ding Xiaoming; Feng Xinshun; Jin Zhankui

    2008-01-01

    Objective To investigate the effect of prostaglandin E: (PGE1) on recovery of early renal graft functions after transplantation. Methods One hundred and seven patients after renal transplantation were allocated in the treated group, and treated by conventional treatment with injection of 10 μg prostaglandin E1 additionally twice a day for 14 days. And eighty-eight patients who received conventional treatment alone after renal transplantation at the corresponding period were allocated in the control group. Indexes of the two groups, including incidence of delayed graft function and acute rejection reaction, volume of urine, serum certaintie (SCr), endogenous certainties clearance rate (CCr), the blood flow resistance in graft as well as blood viscosity (BV), and platelet aggregation rate (PAR), were determined. Results The urinary volume and endogenous certainties clearance rate of the treated group were significantly higher, but the level of SCr, incidence of renal function recovery retardation, BV, PAR and blood flow resistance in graft were significantly lower than these of the control group (P0.05). Conclusion Prostaglandin E1 can improve blood microcirculation and decrease the incidence of renal function recovery retardation. These effects are helpful for recovery of renal function after renal transplantation.

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

    International Nuclear Information System (INIS)

    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

  4. Hydrogen Sulfide Inhibits High-Salt Diet-Induced Renal Oxidative Stress and Kidney Injury in Dahl Rats.

    Science.gov (United States)

    Huang, Pan; Shen, Zhizhou; Liu, Jia; Huang, Yaqian; Chen, Siyao; Yu, Wen; Wang, Suxia; Ren, Yali; Li, Xiaohui; Tang, Chaoshu; Du, Junbao; Jin, Hongfang

    2016-01-01

    BACKGROUND. The study was designed to investigate if H2S could inhibit high-salt diet-induced renal excessive oxidative stress and kidney injury in Dahl rats. METHODS. Male salt-sensitive Dahl and SD rats were used. Blood pressure (BP), serum creatinine, urea, creatinine clearance rate, and 24-hour urine protein were measured. Renal ultra- and microstructures were observed. Collagen-I and -III contents the oxidants and antioxidants levels in renal tissue were detected. Keap1/Nrf2 association and Keap1 s-sulfhydration were detected. RESULTS. After 8 weeks of high-salt diet, BP was significantly increased, renal function and structure were impaired, and collagen deposition was abundant in renal tissues with increased renal MPO activity, H2O2, MDA, GSSG, and (•)OH contents, reduced renal T-AOC and GSH contents, CAT, GSH-PX and SOD activity, and SOD expressions in Dahl rats. Furthermore, endogenous H2S in renal tissues was decreased in Dahl rats. H2S donor, however, decreased BP, improved renal function and structure, and inhibited collagen excessive deposition in kidney, in association with increased antioxidative activity and reduced oxidative stress in renal tissues. H2S activated Nrf2 by inducing Keap1 s-sulfhydration and subsequent Keap1/Nrf2 disassociation. CONCLUSIONS. H2S protected against high-salt diet-induced renal injury associated with enhanced antioxidant capacity and inhibited renal oxidative stress. PMID:26823949

  5. Hydrogen Sulfide Inhibits High-Salt Diet-Induced Renal Oxidative Stress and Kidney Injury in Dahl Rats

    Directory of Open Access Journals (Sweden)

    Pan Huang

    2016-01-01

    Full Text Available Background. The study was designed to investigate if H2S could inhibit high-salt diet-induced renal excessive oxidative stress and kidney injury in Dahl rats. Methods. Male salt-sensitive Dahl and SD rats were used. Blood pressure (BP, serum creatinine, urea, creatinine clearance rate, and 24-hour urine protein were measured. Renal ultra- and microstructures were observed. Collagen-I and -III contents the oxidants and antioxidants levels in renal tissue were detected. Keap1/Nrf2 association and Keap1 s-sulfhydration were detected. Results. After 8 weeks of high-salt diet, BP was significantly increased, renal function and structure were impaired, and collagen deposition was abundant in renal tissues with increased renal MPO activity, H2O2, MDA, GSSG, and •OH contents, reduced renal T-AOC and GSH contents, CAT, GSH-PX and SOD activity, and SOD expressions in Dahl rats. Furthermore, endogenous H2S in renal tissues was decreased in Dahl rats. H2S donor, however, decreased BP, improved renal function and structure, and inhibited collagen excessive deposition in kidney, in association with increased antioxidative activity and reduced oxidative stress in renal tissues. H2S activated Nrf2 by inducing Keap1 s-sulfhydration and subsequent Keap1/Nrf2 disassociation. Conclusions. H2S protected against high-salt diet-induced renal injury associated with enhanced antioxidant capacity and inhibited renal oxidative stress.

  6. Megalin is essential for renal proximal tubule reabsorption and accumulation of transcobalamin-B(12)

    DEFF Research Database (Denmark)

    Birn, Henrik; Willnow, Thomas E; Nielsen, Rikke;

    2002-01-01

    Megalin has previously been shown to bind and mediate endocytosis of transcobalamin (TC)-B(12). However, the physiological significance of this has not been established, and other TC-B(12) binding proteins have been suggested to mediate renal uptake of this vitamin complex. The present study...... demonstrates by the use of megalin-deficient mice that megalin is, in fact, essential for the normal renal reabsorption of TC-vitamin B(12) and for renal accumulation of this highly conserved vitamin. Megalin-deficient mice excrete increased amounts of TC and B(12) in the urine, revealing a defective renal...... tubular uptake of TC-B(12). The urinary B(12) excretion is increased approximately 4-fold, resulting in an approximately 28-fold higher renal B(12) clearance. This is associated with an approximately 4-fold decrease in B(12) content in megalin-deficient kidney cortex. Thus megalin is important to prevent...

  7. Glial K(+) Clearance and Cell Swelling

    DEFF Research Database (Denmark)

    Macaulay, Nanna; Zeuthen, Thomas

    2012-01-01

    An important feature of neuronal signalling is the increased concentration of K(+) in the extracellular space. The K(+) concentration is restored to its original basal level primarily by uptake into nearby glial cells. The molecular mechanisms by which K(+) is transferred from the extracellular...... space into the glial cell are debated. Although spatial buffer currents may occur, their quantitative contribution to K(+) clearance is uncertain. The concept of spatial buffering of K(+) precludes intracellular K(+) accumulation and is therefore (i) difficult to reconcile with the K(+) accumulation...... repeatedly observed in glial cells during K(+) clearance and (ii) incompatible with K(+)-dependent glial cell swelling. K(+) uptake into non-voltage clamped cultured glial cells is carried out by the Na(+)/K(+)-ATPase and the Na(+)/K(+)/Cl(-) cotransporter in combination. In brain slices and intact optic...

  8. Renal extraction and acute effects of glucagon-like peptide-1 on central and renal hemodynamics in healthy men.

    Science.gov (United States)

    Asmar, Ali; Simonsen, Lene; Asmar, Meena; Madsbad, Sten; Holst, Jens J; Frandsen, Erik; Moro, Cedric; Jonassen, Thomas; Bülow, Jens

    2015-04-15

    The present experiments were performed to elucidate the acute effects of intravenous infusion of glucagon-like peptide (GLP)-1 on central and renal hemodynamics in healthy men. Seven healthy middle-aged men were examined on two different occasions in random order. During a 3-h infusion of either GLP-1 (1.5 pmol·kg⁻¹·min⁻¹) or saline, cardiac output was estimated noninvasively, and intraarterial blood pressure and heart rate were measured continuously. Renal plasma flow, glomerular filtration rate, and uptake/release of hormones and ions were measured by Fick's Principle after catheterization of a renal vein. Subjects remained supine during the experiments. During GLP-1 infusion, both systolic blood pressure and arterial pulse pressure increased by 5±1 mmHg (P=0.015 and P=0.002, respectively). Heart rate increased by 5±1 beats/min (P=0.005), and cardiac output increased by 18% (P=0.016). Renal plasma flow and glomerular filtration rate as well as the clearance of Na⁺ and Li⁺ were not affected by GLP-1. However, plasma renin activity decreased (P=0.037), whereas plasma levels of atrial natriuretic peptide were unaffected. Renal extraction of intact GLP-1 was 43% (Pvolume and heart rate, whereas no effect on renal hemodynamics could be demonstrated despite significant extraction of both the intact hormone and its primary metabolite. PMID:25670826

  9. ADSORBENTS USED IN THE CLEARANCE OF ENDOTOXIN

    Institute of Scientific and Technical Information of China (English)

    YU Mei; LIU Tao; Hou Guanghui; YUAN Zhi

    2003-01-01

    A series of modified poly (methyl methacrylate, PMMA) resins were prepared and compared their adsorption abilities to endotoxin. The results showed that adsorbents, which were grafted with tertiary amine and long spacing arms, had the best adsorption capacities and good blood compatibility, It is hopeful to be used as adsorbent in hemoperfusion for clinical clearance of endotoxin. The influence of original concentration of endotoxin on adsorption and the adsorption mechanism were also investigated.

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

    Energy Technology Data Exchange (ETDEWEB)

    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

  11. Recurrent renal giant leiomyosarcoma.

    Science.gov (United States)

    Öziş, Salih Erpulat; Gülpınar, Kamil; Şahlı, Zafer; Konak, Baha Burak; Keskin, Mete; Özdemir, Süleyman; Ataoğlu, Ömür

    2016-01-01

    Primary renal leiomyosarcomas are rare, aggressive tumors. They constitute 1-2% of adult malignant renal tumors. Although leiomyosarcomas are the most common histological type (50-60%) of renal sarcomas, information on renal leiomyosarcoma is limited. Local or systemic recurrences are common. The radiological appearance of renal leiomyosarcomas is not specific, therefore renal leiomyosarcoma cannot be distinguished from renal cell carcinoma by imaging methods in all patients. A 74-year-old female patient presented to our clinic complaining of a palpable mass on the right side of her abdomen in November 2012. The abdominal magnetic resonance imaging revealed a mass, 25 × 24 × 23 cm in size. Her past medical history revealed that she has undergone right radical nephrectomy in 2007, due to a 11 × 12 × 13 cm renal mass that was then reported as renal cell carcinoma on abdominal magnetic resonance imaging, but the pathological diagnosis was low-grade renal leiomyosarcoma. The most recent follow-up of the patient was in 2011, with no signs of local recurrence or distant metastases within this four-year period. The patient underwent laparotomy on November 2012, and a 35 cm retroperitoneal mass was excised. The pathological examination of the mass was reported as high-grade leiomyosarcoma. The formation of this giant retroperitoneal mass in 1 year can be explained by the transformation of the lesion's pathology from low-grade to a high-grade tumor. PMID:27436926

  12. Renal Preservation Therapy for Renal Cell Carcinoma

    OpenAIRE

    Yichun Chiu; Allen W. Chiu

    2012-01-01

    Renal preservation therapy has been a promising concept for the treatment of localized renal cell carcinoma (RCC) for 20 years. Nowadays partial nephrectomy (PN) is well accepted to treat the localized RCC and the oncological control is proved to be the same as the radical nephrectomy (RN). Under the result of well oncological control, minimal invasive method gains more popularity than the open PN, like laparoscopic partial nephrectomy (LPN) and robot assisted laparoscopic partial nephrectomy...

  13. Renal function after renal artery stenting

    Institute of Scientific and Technical Information of China (English)

    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

  14. Recovery of renal function in dialysis patients

    Directory of Open Access Journals (Sweden)

    Patlovany Matthew

    2003-10-01

    Full Text Available Abstract Background Although recovery of renal functions in dialysis dependent patients is estimated to be greater than 1%, there are no indicators that actually suggest such revival of renal function. Residual renal function in dialysis patients is unreliable and seldom followed. Therefore renal recovery (RR in dialysis dependent patients may remain unnoticed. We present a group of dialysis dependent patients who regained their renal functions. The aim of this project is to determine any indicators that may identify the recovery of renal functions in dialysis dependent patients. Methods All the discharges from the chronic dialysis facilities were identified. Among these discharges deaths, transplants, voluntary withdrawals and transfers either to another modality or another dialysis facility were excluded in order to isolate the patients with RR. The dialysis flow sheets and medical records of these patients were subsequently reviewed. Results Eight patients with a mean age of 53.8 ± 6.7 years (± SEM were found to have RR. Dialysis was initiated due to uremic symptoms in 6 patients and fluid overload in the remaining two. The patients remained dialysis dependent for 11.1 ± 4.2 months. All these patients had good urine output and 7 had symptoms related to dialysis. Their mean pre-initiation creatinine and BUN levels were 5.21 ± 0.6 mg/dl and 72.12 ± 11.12 mg/dl, respectively. Upon discontinuation, they remained dialysis free for 19.75 ± 5.97 months. The mean creatinine and BUN levels after cessation of dialysis were 2.85 ± 0.57 mg/dl and 29.62 ± 5.26 mg/dl, respectively, while the mean creatinine clearance calculated by 24-hour urine collection was 29.75 ± 4.78 ml/min. One patient died due to HIV complications. One patient resumed dialysis after nine months. Remaining continue to enjoy a dialysis free life. Conclusion RR must be considered in patients with good urine output and unresolved acute renal failure. Dialysis intolerance may be

  15. Airway Clearance Devices for Cystic Fibrosis

    Science.gov (United States)

    2009-01-01

    Executive Summary Objective The purpose of this evidence-based analysis is to examine the safety and efficacy of airway clearance devices (ACDs) for cystic fibrosis and attempt to differentiate between devices, where possible, on grounds of clinical efficacy, quality of life, safety and/or patient preference. Background Cystic fibrosis (CF) is a common, inherited, life-limiting disease that affects multiple systems of the human body. Respiratory dysfunction is the primary complication and leading cause of death due to CF. CF causes abnormal mucus secretion in the airways, leading to airway obstruction and mucus plugging, which in turn can lead to bacterial infection and further mucous production. Over time, this almost cyclical process contributes to severe airway damage and loss of respiratory function. Removal of airway secretions, termed airway clearance, is thus an integral component of the management of CF. A variety of methods are available for airway clearance, some requiring mechanical devices, others physical manipulation of the body (e.g. physiotherapy). Conventional chest physiotherapy (CCPT), through the assistance of a caregiver, is the current standard of care for achieving airway clearance, particularly in young patients up to the ages of six or seven. CF patients are, however, living much longer now than in decades past. The median age of survival in Canada has risen to 37.0 years for the period of 1998-2002 (5-year window), up from 22.8 years for the 5-year window ending in 1977. The prevalence has also risen accordingly, last recorded as 3,453 in Canada in 2002, up from 1,630 in 1977. With individuals living longer, there is a greater need for independent methods of airway clearance. Airway Clearance Devices There are at least three classes of airway clearance devices: positive expiratory pressure devices (PEP), airway oscillating devices (AOD; either handheld or stationary) and high frequency chest compression (HFCC)/mechanical percussion (MP

  16. Imaging of renal osteodystrophy

    Energy Technology Data Exchange (ETDEWEB)

    Jevtic, V. E-mail: vladimir.jevtic@mf.uni-lj.si

    2003-05-01

    Chronic renal insufficiency, hemodialysis, peritoneal dialysis, renal transplantation and administration of different medications provoke complex biochemical disturbances of the calcium-phosphate metabolism with wide spectrum of bone and soft tissue abnormalities termed renal osteodystrophy. Clinically most important manifestation of renal bone disease includes secondary hyperparathyroidism, osteomalacia/rickets, osteoporosis, adynamic bone disease and soft tissue calcification. As a complication of long-term hemodialysis and renal transplantation amyloid deposition, destructive spondyloarthropathy, osteonecrosis, and musculoskeletal infections may occur. Due to more sophisticated diagnostic methods and more efficient treatment classical radiographic features of secondary hyperparathyroidism and osteomalacia/rickets are now less frequently seen. Radiological investigations play an important role in early diagnosis and follow-up of the renal bone disease. Although numerous new imaging modalities have been introduced in clinical practice (scintigraphy, CT, MRI, quantitative imaging), plain film radiography, especially fine quality hand radiograph, still represents most widely used examination.

  17. Incidental renal neoplasms

    DEFF Research Database (Denmark)

    Rabjerg, Maj; Mikkelsen, Minne Nedergaard; Walter, Steen;

    2014-01-01

    On the basis of associations between tumor size, pathological stage, histological subtype and tumor grade in incidentally detected renal cell carcinoma vs symptomatic renal cell carcinoma, we discussed the need for a screening program of renal cell carcinoma in Denmark. We analyzed a consecutive...... series of 204 patients with renal tumors in 2011 and 2012. The tumors were classified according to detection mode: symptomatic and incidental and compared to pathological parameters. Eighty-nine patients (44%) were symptomatic, 113 (55%) were incidental. Information was not available in two patients...

  18. [Ratio of amylase clearance and creatinine clearance in the diagnosis of acute pancreatitis].

    Science.gov (United States)

    Haffter, D; Reichlin, B; Gyr, K

    1981-05-30

    In 21 healthy volunteers the ratio of amylase clearance and creatinine clearance (Cam/Ccr) was determined in urine collected at admission, after a 1-hour collection period and after a 2-hour collection period. The normal values were 1.8 +/- 1.6%, 1.9 +/- 2% and 2.0 +/- 1.7% respectively. They were comparable with those published by others. The reproducibility of the method was acceptable (r = 0.62). When compared with serum amylase determinations, Cam/Ccr showed neither better sensitivity in 19 patients suffering an acute episode of proven pancreatitis, nor better specificity in 19 patients with acute abdomen but no evidence of pancreatitis.

  19. Renal (Kidney) Manifestations in TSC

    Medline Plus

    Full Text Available ... methods to diagnosis these renal abnormalities include renal ultrasonography, CT scanning and magnetic resonance imaging (MRI). These ... in almost every major medical center. The renal ultrasound provides the least detailed image of the kidney, ...

  20. Renal pelvis or ureter cancer

    Science.gov (United States)

    Transitional cell cancer of the renal pelvis or ureter; Kidney cancer - renal pelvis; Ureter cancer ... the urine collection system, but it is uncommon. Renal pelvis and ureter cancers affect men more often ...

  1. Renal (Kidney) Manifestations in TSC

    Medline Plus

    Full Text Available ... the kidneys are filled with cysts. If kidney failure occurs, renal replacement therapy such as dialysis or transplantation is ... can develop in infancy or early childhood and renal failure most often occurs in early adulthood. Renal Angiomyolipomas ...

  2. Resistance of the rat to development of lead-induced renal functional deficits

    Energy Technology Data Exchange (ETDEWEB)

    O' Flaherty, E.J.; Adams, W.D.; Hammond, P.B.; Taylor, E.

    1986-01-01

    Lead nephropathy, characterized functionally by depression of effective renal plasma flow (ERPF), glomerular filtration rate (GFR), and maximum glucose reabsorption rate, is associated with prolonged occupational exposure to lead. Production of comparable lead-related renal functional deficits in rats has been difficult to achieve. The authors have examined in rats some of the factors that might be expected to influence the development of lead-induced renal functional damage, using GFR (as inulin clearance). ERPF (as para-aminohippurate clearance), and maximum glucose readsorption rates as indices of renal functional competence. Although lead produces a significant weight loss, this can be accounted for by reduced food intake and is not associated with reduction in renal function. Even exposure to large amounts of lead in conjunction with other factors; such as controlled diet (NIH-07 and AIN-76) and early age of initial exposure, that might have been expected to increase the rats' susceptibility has not resulted in the development of renal functional deficits. It is unlikely that the rat can be successfully explored as an animal model of human lead nephropathy with accompanying functional deficits.

  3. Relationship of glomerular filtration rate based on serum iodixanol clearance to IRIS staging in cats with chronic kidney disease.

    Science.gov (United States)

    Iwama, Ryosuke; Sato, Tsubasa; Katayama, Masaaki; Shimamura, Shunsuke; Satoh, Hiroshi; Ichijo, Toshihiro; Furuhama, Kazuhisa

    2015-08-01

    We examined the correlation between the glomerular filtration rate (GFR) estimated from an equation based on the serum iodixanol clearance technique and International Renal Interest Society (IRIS) stages of chronic kidney disease (CKD) in cats. The equation included the injection dose, sampling time, serum concentration and estimated volume of distribution (Vd) of the isotonic, nonionic, contrast medium iodixanol as a test tracer. The percent changes in the median basal GFR values calculated from the equation in CKD cats resembled those of IRIS stages 1-3. These data validate the association between the GFR derived from the simplified equation and IRIS stages based on the serum creatinine concentration in cats with CKD. They describe the GFR ranges determined using single-sample iodixanol clearance for healthy cats and cats with various IRIS stages of CKD. PMID:25864431

  4. Clearance and release from control - An international perspective

    International Nuclear Information System (INIS)

    This paper tries to give an overview of the clearance, or release from regulatory control, on an international scale, including some of those countries where clearance has become or is about to become vital for D and D. The emphasis lies on the impact of clearance, and in particular of differences between clearance levels of various countries, on D and D. Relevance of clearance for D and D of nuclear installations Clearance is an essential part of waste management (or more general, material management) in nuclear installations, and in particular during the decommissioning phase where waste streams continues to arise. Of course, the relevance of clearance in a particular country depends on a number of factors, like: availability of a final repository and its price; prevailing decommissioning strategy; number of nuclear installations reaching decommissioning phase. This small selection of reasons why clearance may be of varying importance for different countries may already suffice to illustrate why up to now clearance has been developed and implemented in quite different ways. If one thinks of additional reasons that may influence clearance, like politics, the public opinion, availability of funds etc., the situation becomes even more complex. It is, however safe to draw the conclusion that countries with a certain number of nuclear installations which have been or will soon be shut down or which are already in the decommissioning phase will need to implement provisions for clearance. This has indeed been the case with countries like the UK, Germany, the USA, Sweden, and a number of others. It is not essential for clearance levels to be exactly equal between various countries. They may differ as long as the difference is not too large, e.g. the values fall into the same order of magnitude. This is the reason why for example Germany has no problems with clearance levels which differ from the EU recommendation RP 122 partially adopted in a number of EU countries

  5. Amylase creatinine clearance ratio after biliary surgery.

    Science.gov (United States)

    Donaldson, L A; McIntosh, W; Joffe, S N

    1977-01-01

    The amylase creatinine clearance ratio (ACCR) is considered to be a more sensitive index of acute pancreatitis than the serum amylase level. Serial ACCR estimations were undertaken in 25 patients undergoing an elective cholecystectomy. Using accepted criteria, 28% of these patients developed, in the postoperative period, biochemical evidence of pancreatic gland damage, although the serum amylase level remained normal. This raised ACCR was particularly noted in patients who had undergone an exploration of the common bile duct. The ACCR would appear to be a more sensitive index of pancreatic gland disruption secondary to biliary surgery than the serum amylase level.

  6. Amylase creatinine clearance ratio after biliary surgery.

    Science.gov (United States)

    Donaldson, L A; McIntosh, W; Joffe, S N

    1977-01-01

    The amylase creatinine clearance ratio (ACCR) is considered to be a more sensitive index of acute pancreatitis than the serum amylase level. Serial ACCR estimations were undertaken in 25 patients undergoing an elective cholecystectomy. Using accepted criteria, 28% of these patients developed, in the postoperative period, biochemical evidence of pancreatic gland damage, although the serum amylase level remained normal. This raised ACCR was particularly noted in patients who had undergone an exploration of the common bile duct. The ACCR would appear to be a more sensitive index of pancreatic gland disruption secondary to biliary surgery than the serum amylase level. PMID:402305

  7. Distal renal tubular acidosis in recurrent renal stone formers

    DEFF Research Database (Denmark)

    Osther, P J; Hansen, A B; Røhl, H F

    1989-01-01

    Renal acidification ability was examined in 90 recurrent renal stone formers, using fasting morning urinary pH levels followed by a short ammonium chloride loading test in subjects with pH levels above 6.0. Fifteen patients (16.6%) revealed a distal renal tubular acidification defect: one patient...... (1.1%) had complete distal renal tubular acidosis and 14 (15.5%) incomplete distal renal tubular acidosis. Our results confirm that distal renal tubular acidification defects are associated with a more severe form of stone disease and make distal renal tubular acidosis one of the most frequent...... metabolic disturbances in renal stone formers. Distal renal tubular acidosis (dRTA) was relatively more common in female stone formers and most often found in patients with bilateral stone disease (36%). Since prophylactic treatment in renal stone formers with renal acidification defects is available...

  8. Quantitative analysis of hippuric acid nephrograms - clearance studied by means of a compartment technique with special regard to the labelling with I-123

    International Nuclear Information System (INIS)

    A new nuclear-medical technique is presented: the compartmental analysis of radio hippuran (=OIN)-nephrograms. By means of this method global, divided or regional tubular clearance can be determined for this substance. The original data of a time-dependent activity course are compared with the data of a theoretical, mathematical model and are varied by means of graded modification of single parameters until a tolerable deviation results. The mathematical model bases on a six-compartment model which defines the in-vivo kinetics of OIH. For the clearance calculations only the impulse rates of the nephrograms and those of a basic curve are required, which are obtained from camera sequence scintiscanning by means of common data processing. In all 182 patients the tubular clearances were determined by means of this procedure. The correlative calculations or the referential methods provided good (J-131-OIH) to excellent (J-123-OIH) results. In this study the significance of the parameters is discussed, which occur routinely in compartmental analysis and indicate renal excretionary performance. The advantages resulting from the administration of J-123-hippuran are explained. The advantages due to the compartmental analysis of the camera nephrogram with respect to usual methods applied for tubular renal clearance determination are obvious. These advantages are obtained without provoking a loss of precision. Recommendations with respect to the routine application of the new procedure are concluded. (orig./MG)

  9. Study of blade clearance effects on centrifugal pumps

    Science.gov (United States)

    Hoshide, R. K.; Nielson, C. E.

    1972-01-01

    A program of analysis, design, fabrication, and testing has been conducted to develop and experimentally verify analytical models to predict the effects of impeller blade clearance on centrifugal pumps. The effect of tip clearance on pump efficiency, and the relationship between the head coefficient and torque loss with tip clearance was established. Analysis were performed to determine the cost variation in design, manufacture, and test that would occur between unshrouded and shrouded impellers. An impeller, representative of typical rocket engine impellers, was modified by removing its front shroud to permit variation of its blade clearances. It was tested in water with special instrumentation to provide measurements of blade surface pressures during operation. Pump performance data were obtained from tests at various impeller tip clearances. Blade pressure data were obtained at the nominal tip clearance. Comparisons of predicted and measured data are given.

  10. Renal Function in Hypothyroidism

    International Nuclear Information System (INIS)

    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).

  11. Hepatic and renal extraction of circulating type III procollagen amino-terminal propeptide and hyaluronan in pig

    DEFF Research Database (Denmark)

    Bentsen, K D; Henriksen, Jens Henrik Sahl; Boesby, S;

    1989-01-01

    Hepatic and renal clearance of the amino-terminal propeptide of type III procollagen (PIIINP) and of the glycosaminoglycan, hyaluronan (HA) were investigated in a catheterization study of seven healthy anesthetized pigs. Two assays were used, in order to distinguish between the metabolism of...

  12. Eligibility for renal denervation

    DEFF Research Database (Denmark)

    Persu, Alexandre; Jin, Yu; Baelen, Marie;

    2014-01-01

    Based on the SYMPLICITY studies and CE (Conformité Européenne) certification, renal denervation is currently applied as a novel treatment of resistant hypertension in Europe. However, information on the proportion of patients with resistant hypertension qualifying for renal denervation after...... a thorough work-up and treatment adjustment remains scarce. The aim of this study was to investigate the proportion of patients eligible for renal denervation and the reasons for noneligibility at 11 expert centers participating in the European Network COordinating Research on renal Denervation in treatment......-resistant hypertension (ENCOReD). The analysis included 731 patients. Age averaged 61.6 years, office blood pressure at screening was 177/96 mm Hg, and the number of blood pressure-lowering drugs taken was 4.1. Specialists referred 75.6% of patients. The proportion of patients eligible for renal denervation according...

  13. Primary renal hydatidosis

    Directory of Open Access Journals (Sweden)

    Johnsy Merla Joel

    2016-01-01

    Full Text Available Echinococcosis or hydatidosis caused by the tapeworm, Echinococcus granulosus, has the highest prevalence in endemic regions and sheep farming areas. The most common organ involved is the liver (50–75% followed by the lungs (15–20% and other organs (10–20%. Primary involvement of the kidney without the involvement of the liver and lungs, i.e., isolated renal hydatid disease is extremely rare even in endemic areas. The incidence of renal echinococcosis is 2–4%. Renal hydatid cysts usually remain asymptomatic for many years and are multiloculated. A 63-year-old male presented with left loin pain. Computed tomography scan abdomen revealed a presumptive diagnosis of renal hydatid disease. The nephrectomy specimen received in histopathology confirmed the diagnosis. We describe a rare case of primary renal hydatidosis.

  14. Facile synthesis, pharmacokinetic and systemic clearance evaluation, and positron emission tomography cancer imaging of 64Cu-Au alloy nanoclusters

    Science.gov (United States)

    Zhao, Yongfeng; Sultan, Deborah; Detering, Lisa; Luehmann, Hannah; Liu, Yongjian

    2014-10-01

    Gold nanoparticles have been widely used for oncological applications including diagnosis and therapy. However, the non-specific mononuclear phagocyte system accumulation and potential long-term toxicity have significantly limited clinical translation. One strategy to overcome these shortcomings is to reduce the size of gold nanoparticles to allow renal clearance. Herein, we report the preparation of 64Cu alloyed gold nanoclusters (64CuAuNCs) for in vivo evaluation of pharmacokinetics, systemic clearance, and positron emission tomography (PET) imaging in a mouse prostate cancer model. The facile synthesis in acqueous solution allowed precisely controlled 64Cu incorporation for high radiolabeling specific activity and stability for sensitive and accurate detection. Through surface pegylation with 350 Da polyethylene glycol (PEG), the 64CuAuNCs-PEG350 afforded optimal biodistribution and significant renal and hepatobiliary excretion. PET imaging showed low non-specific tumor uptake, indicating its potential for active targeting of clinically relevant biomarkers in tumor and metastatic organs.Gold nanoparticles have been widely used for oncological applications including diagnosis and therapy. However, the non-specific mononuclear phagocyte system accumulation and potential long-term toxicity have significantly limited clinical translation. One strategy to overcome these shortcomings is to reduce the size of gold nanoparticles to allow renal clearance. Herein, we report the preparation of 64Cu alloyed gold nanoclusters (64CuAuNCs) for in vivo evaluation of pharmacokinetics, systemic clearance, and positron emission tomography (PET) imaging in a mouse prostate cancer model. The facile synthesis in acqueous solution allowed precisely controlled 64Cu incorporation for high radiolabeling specific activity and stability for sensitive and accurate detection. Through surface pegylation with 350 Da polyethylene glycol (PEG), the 64CuAuNCs-PEG350 afforded optimal

  15. The renal handling of sodium and water is not affected by the standard-dose cisplatin treatment for testicular cancer

    DEFF Research Database (Denmark)

    Daugaard, G; Strandgaard, S; Holstein-Rathlou, N H;

    1987-01-01

    Renal clearances of 51Cr-EDTA, lithium, sodium and potassium were measured before and after each of four consecutive treatment series with cisplatin in 15 men with testicular cancer. Since lithium is reabsorbed like sodium and water in the proximal tubules, but not reabsorbed to any measurable...... and all other parameters of glomerular filtration and renal sodium handling remained normal throughout the study (with the exception of a fall in fractional sodium excretion after the first treatment series). Plasma magnesium declined during all four treatment periods, signifying renal magnesium wasting....

  16. Marcadores práticos de função renal em pacientes com cistinose

    Directory of Open Access Journals (Sweden)

    Luciana Pache de Faria Guimaraes

    2012-09-01

    Full Text Available INTRODUÇÃO: Cistinose é uma doença sistêmica, autossômica recessiva, que leva à insuficiência renal crônica na infância, a não ser que o tratamento com cisteamina seja iniciado precocemente. Mesmo nestas condições, os pacientes evoluem para doença renal crônica terminal por volta da segunda década da vida. Portanto, a avaliação da função renal é essencial neste grupo de pacientes. OBJETIVO: Avaliar e correlacionar a cistatina C, creatinina sérica e o clearance de creatinina pela Fórmula de Schwartz em pacientes com cistinose, com diferentes graus de função renal. MÉTODOS: Foram incluídos pacientes com menos de 18 anos de idade, com diferentes níveis de função renal, de acordo com o KDOQI em estágios 1 a 4. Nenhum dos pacientes estava em terapia de substituição renal. Foram medidos os seguintes parâmetros: cistatina C, creatinina sérica e o clearance de creatinina pela fórmula de Schwartz. RESULTADOS: Foram analisadas 103 amostras de sangue de 26 pacientes. Foi detectada correlação significativa entre creatinina sérica e cistatina C (r = 0,81, p < 0,0001, cistatina C e o clearance de creatinina pela fórmula de Schwartz (r = -0,84, p < 0,0001 e creatinina sérica e clearance de creatinina (r = -0,97, p < 0,0001. CONCLUSÕES: A medida da cistatina não mostrou nenhuma vantagem sobre a creatinina sérica e o clearance de creatinina pela fórmula de Schwartz em pacientes com cistinose para avaliar o ritmo de filtração glomerular. Este é o primeiro relato sobre o valor da creatinina sérica, do clearance de creatinina pela fórmula de Schwartz e da cistatina C em pacientes com cistinose.

  17. Abnormalities of the breast in chronic renal failure and renal transplantation

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Bae Young; Kim, Hak Hee; Choi, Kyu Ho; Park, Seog Hee [The Catholic University of Korea College of Medicine, Seoul (Korea, Republic of)

    2000-12-15

    Manifestations of breast abnormalities in these patients included breast calcifications, duct dilatation, fibrocystic change, rapidly enlarged multiple fibroadenomas, edema, invasive ductal cancer, extensive fibrosis, spontaneous hemorrhage, and Mondor's disease. These interesting cases we experienced are reported. Prolactin, growth hormone, and cortisol are required concurrently for normal development of mammary epithelium. Hormonal profile of chronic renal failure is different to normal person due to decreased renal clearance. The incidence of breast cancer is also increased in CRF. Metastatic soft tissue calcification is well described finding in chronic renal failure related to an increase in serum calcium phosphate product and secondary hyperparathyroidism. Kidney failure alone may increases prolactin level. The possibility of deranged hypothalamic-pituitary control mechanisms do not excluded. Impaired prolactin response to TRH stimulation has also been observed. Methyldopa and tricyclic antidepressants specifically were associated with hyperprolactinemia. Cyclosporin administration may elevate serum prolactin levels with simultaneous down regulation of prolactin receptors. Some populations of lymphocytes and fibroblasts exhibit cyclosporin receptors. Cyclosporin could potentially promote fibroadenomas by direct action, and seems to alter LH secretion.

  18. Abnormalities of the breast in chronic renal failure and renal transplantation

    International Nuclear Information System (INIS)

    Manifestations of breast abnormalities in these patients included breast calcifications, duct dilatation, fibrocystic change, rapidly enlarged multiple fibroadenomas, edema, invasive ductal cancer, extensive fibrosis, spontaneous hemorrhage, and Mondor's disease. These interesting cases we experienced are reported. Prolactin, growth hormone, and cortisol are required concurrently for normal development of mammary epithelium. Hormonal profile of chronic renal failure is different to normal person due to decreased renal clearance. The incidence of breast cancer is also increased in CRF. Metastatic soft tissue calcification is well described finding in chronic renal failure related to an increase in serum calcium phosphate product and secondary hyperparathyroidism. Kidney failure alone may increases prolactin level. The possibility of deranged hypothalamic-pituitary control mechanisms do not excluded. Impaired prolactin response to TRH stimulation has also been observed. Methyldopa and tricyclic antidepressants specifically were associated with hyperprolactinemia. Cyclosporin administration may elevate serum prolactin levels with simultaneous down regulation of prolactin receptors. Some populations of lymphocytes and fibroblasts exhibit cyclosporin receptors. Cyclosporin could potentially promote fibroadenomas by direct action, and seems to alter LH secretion.

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

    DEFF Research Database (Denmark)

    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....

  20. Managing new-onset gout in pediatric renal transplant recipients: when, how, to what extent.

    Science.gov (United States)

    Assadi, Farahnak

    2013-01-01

    Hyperuricemia and gout are common among adult renal transplant recipients, but it is rarely reported following pediatric renal transplantations. Treating gout in pediatric kidney transplant recipients presents clinical challenges to the management of both immunosuppressive regimen and hyperuricemia for their effects on serum uric acid levels, renal function and drug interactions. Most renal transplant recipients have a relative impairment of renal clearance of urate due to abnormalities in renal transport, explaining the association of hyperuricemia and decreased glomerular filtration rate. Risk factors for the development of gout include impaired renal function, hypertension, heart failure and diabetes mellitus. Calcineurin inhibitors, particularly cyclosporine, are the most important risk factor for gout in transplant recipients and should not be used in pediatric renal transplant recipients. Diuretic therapy increases the risk of gout by causing extracellular volume contraction with consequent enhancement of proximal tubular reabsorption. Corticosteroids are increasingly replacing nonsteroidal antiinflammatory drugs and colchicine for the treatment of acute gout flares because they have little effect on kidney function. Proper management is aimed at lowering serum uric acid level below 6.0 mg/dL with xanthine oxidase inhibitors such as allopurinol or febuxostat. Allopurinol and mycophenolate mofetil are safer to use in combination than are allopurinol and azathioprine. Febuxostat is an alternative to allopurinol in patients with allopurinol intolerance or hypersensitivity. Pegloticase is indicated for patients with severe gout in whom allopurinol and febuxostat have not been effective or tolerated. PMID:22941874

  1. Relationships between Serum Levels of Atazanavir and Renal Toxicity or Lithiasis

    Directory of Open Access Journals (Sweden)

    C. I. Marinescu

    2015-01-01

    Full Text Available The main aim of this study is to describe the relationship between serum levels of atazanavir, renal toxicity, and lithiasis. This is a prospective observational study of patients being treated with atazanavir (ATV at Son Espases Teaching Hospital, Palma de Mallorca, between 2011 and 2013. The study includes 98 patients. Sixteen were found to have a history of urolithiasis. During a median monitoring period of 23 months, nine patients suffered renal colic, in three of whom ATV crystals were evidenced in urine. Cumulative incidence of renal colic was 9.2 per 100 patients. The variables related to having renal colic were the presence of alkaline urine pH and lower basal creatinine clearance. The mean serum level of ATV was slightly higher in patients with renal colic—1,303 μg/L versus 1,161 μg/L—but did not reach statistical significance. Neither were any significant differences detected by analysing the levels according to the timetable for ATV dosage. Cumulative incidence of renal colic was high in patients being treated with ATV, in 33% of whom the presence of ATV crystals was evidenced in urine. We were unable to demonstrate a relationship between ATV serum levels and renal colic or progression towards renal failure.

  2. Magnetic resonance imaging of renal involvement in genetically studied patients with tuberous sclerosis complex

    Energy Technology Data Exchange (ETDEWEB)

    Pompili, Giovanni [Department of Radiology, University of Milan School of Medicine, San Paolo Hospital, Via A. di Rudini 8, 20142 Milan (Italy)], E-mail: gpompili@sirm.org; Zirpoli, Salvatore [Department of Radiology, University of Milan School of Medicine, San Paolo Hospital, Via A. di Rudini 8, 20142 Milan (Italy)], E-mail: szirpoli@sirm.org; Sala, Chiara [Department of Radiology, University of Milan School of Medicine, San Paolo Hospital, Via A. di Rudini 8, 20142 Milan (Italy)], E-mail: chiarasala@alice.it; Flor, Nicola [Department of Radiology, University of Milan School of Medicine, San Paolo Hospital, Via A. di Rudini 8, 20142 Milan (Italy)], E-mail: flornic@hotmail.com; Alfano, Rosa Maria [Department of Pathology, University of Milan School of Medicine, San Paolo Hospital, Via A. di Rudini 8, 20142 Milan (Italy)], E-mail: rosa.alfano@ao-sanpaolo.it; Volpi, Angela [Department of Nephrology, University of Milan School of Medicine, San Paolo Hospital, Via A. di Rudini 8, 20142 Milan (Italy)], E-mail: gianfer2004@libero.it; Brancaccio, Diego [Department of Nephrology, University of Milan School of Medicine, San Paolo Hospital, Via A. di Rudini 8, 20142 Milan (Italy)], E-mail: diego.brancaccio@unimi.it; Sardanelli, Francesco [Department of Medical and Surgical Sciences, IRCCS Policlinico San Donato Unit of Radiology, University of Milan School of Medicine (Italy)], E-mail: francesco.sardanelli@unimi.it; Cornalba, Gianpaolo [Department of Radiology, University of Milan School of Medicine, San Paolo Hospital, Via A. di Rudini 8, 20142 Milan (Italy)], E-mail: gianpaolo.cornalba@unimi.it

    2009-11-15

    Purpose: To evaluate renal involvement in tuberous sclerosis complex (TSC). Materials and methods: A series of 24 TSC patients (19 with genetically demonstrated disease), underwent abdominal 1.0-T MR imaging with axial/coronal T1- and T2-weighted scans, with/without fat saturation. We looked for angyomiolipomas (AMLs) and cysts in 47 kidneys of 24 patients. We evaluated the percentage of parenchymal involvement by manual contouring on the coronal scans in 39 kidneys of 20 patients. Results: We detected AMLs in 15/24 (63%) patients and in 27/47 (57%) kidneys, cysts in 14/24 (58%) and in 26/47 (55%); respectively. AMLs were found in 2/4 TSC1 and in 11/15 TSC2 patients, cysts were found in 2/4 TSC1 and in 9/15 TSC2 patients. The global renal involvement ranged from 0 to 32% (median, 18%) in TSC1 and from 0 to 100% (median, 39%) in TSC2 patients. A fair correlation (r = .464) was found between patient's age and renal involvement, a good correlation (r = 0.655) between renal involvement and creatinine clearance. Conclusion: Renal parenchyma of TSC patients can be evaluated with MR imaging. A detectable renal involvement was found in 83% of patients, higher in TSC2 than in TSC1. Renal function seems to correlate with renal involvement quantified with MR imaging.

  3. Renal Preservation Therapy for Renal Cell Carcinoma

    Directory of Open Access Journals (Sweden)

    Yichun Chiu

    2012-01-01

    Full Text Available Renal preservation therapy has been a promising concept for the treatment of localized renal cell carcinoma (RCC for 20 years. Nowadays partial nephrectomy (PN is well accepted to treat the localized RCC and the oncological control is proved to be the same as the radical nephrectomy (RN. Under the result of well oncological control, minimal invasive method gains more popularity than the open PN, like laparoscopic partial nephrectomy (LPN and robot assisted laparoscopic partial nephrectomy (RPN. On the other hand, thermoablative therapy and cryoablation also play an important role in the renal preservation therapy to improve the patient procedural tolerance. Novel modalities, but limited to small number of patients, include high-intensity ultrasound (HIFU, radiosurgery, microwave therapy (MWT, laser interstitial thermal therapy (LITT, and pulsed cavitational ultrasound (PCU. Although initial results are encouraging, their real clinical roles are still under evaluation. On the other hand, active surveillance (AS has also been advocated by some for patients who are unfit for surgery. It is reasonable to choose the best therapeutic method among varieties of treatment modalities according to patients' age, physical status, and financial aid to maximize the treatment effect among cancer control, patient morbidity, and preservation of renal function.

  4. Trimerization of apolipoprotein A-I retards plasma clearance and preserves antiatherosclerotic properties

    DEFF Research Database (Denmark)

    Graversen, Jonas Heilskov; Laurberg, Jacob Marsvin; Andersen, Mikkel Holmen;

    2008-01-01

    An increased plasma level of the major high-density lipoprotein (HDL) component, apolipoprotein A-I (apoA-I) is the aim of several therapeutic strategies for combating atherosclerotic disease. HDL therapy by direct intravenous administration of apoA-I is a plausible way; however, a fast renal...... filtration is a major obstacle for this approach. Using protein engineering technology, we have fused apoA-I to the trimerization domain of human tetranectin and thus constructed a high-mass recombinant trimeric apoA-I variant. The recombinant fusion protein was stable and expressed well; upon purification...... of atherosclerosis in cholesterol-fed low-density lipoprotein receptor-deficient mice. Direct administration of recombinant high-mass apoA-I analogues with retarded clearance is therefore a potential novel therapeutic approach for atherosclerotic plaque stabilization....

  5. [Correlation of the clearance of amylase and creatinine in acute pancreatitis and other pathologies].

    Science.gov (United States)

    Morel, C; Ferraina, P; Valente, A; Cervio, R

    1981-01-01

    The study of a group of 151 patients confirms the diagnostic value of elevated ACCR in pancreatitis, it was positive in 89.4% of them, of the group, 30 were normal, 19 exhibited acute pancreatitis and 102 had various other pathologies. Serious pancreatitis has shown coincide with a long-lasting rise of ACCR, and its rise in the course of the disease was a sign of a new outburst of progressive necrosis. Total unreliability when abnormal creatinine clearance is present was ascertained. The possible mechanism of increase in ACCR has been considered also in connection with the study of the results obtained on a group of patients exhibiting renal insufficiency, gastrointestinal bleeding, acute colecystitis, vesicular lithiasis and obstructive jaundice. PMID:6172947

  6. Predictive factors for renal failure and a control and treatment algorithm

    Directory of Open Access Journals (Sweden)

    Denise de Paula Cerqueira

    2014-04-01

    Full Text Available OBJECTIVES: to evaluate the renal function of patients in an intensive care unit, to identify the predisposing factors for the development of renal failure, and to develop an algorithm to help in the control of the disease.METHOD: exploratory, descriptive, prospective study with a quantitative approach.RESULTS: a total of 30 patients (75.0% were diagnosed with kidney failure and the main factors associated with this disease were: advanced age, systemic arterial hypertension, diabetes mellitus, lung diseases, and antibiotic use. Of these, 23 patients (76.6% showed a reduction in creatinine clearance in the first 24 hours of hospitalization.CONCLUSION: a decline in renal function was observed in a significant number of subjects, therefore, an algorithm was developed with the aim of helping in the control of renal failure in a practical and functional way.

  7. Phenolsulfonphthalein test in healthy sheep and in sheep with reductions in functional renal mass.

    Science.gov (United States)

    Filippich, L J; English, P B; Ainscow, J

    1985-03-01

    The phenolsulfonphthalein (PSP) plasma clearance and urinary excretion tests were applied to sheep before and after 50% and 75% reductions in functional renal mass. The PSP determinants found most useful as indicators of renal mass reduction were the 15-minute urinary excretion percentage and the 60-minute (PSP60) plasma concentration. Although both of these determinants could be used to detect renal mass reduction, the 15-minute PSP excretion percentage was the more sensitive. The PSP60 value was influenced by factors other than reduced nephron numbers; the contraction of the PSP volume of distribution that occurred after renal mass reduction was one important influencing factor. Overall, the PSP tests more accurately reflected the volume of blood delivered to the kidney than the proximal tubular secretory capacity.

  8. Renal infarction in patients presenting with suspected renal colic *

    OpenAIRE

    Seetho, Ian W.; Bungay, Peter M.; Taal, Maarten W.; Fluck, Richard J.; Leung, Janson C. H.

    2009-01-01

    Acute renal infarction is a serious medical emergency. The diagnosis is often delayed or missed as it is not common. Hence, the exact incidence of acute renal infarction is not known. Failure to consider renal infarction in the initial differential diagnosis results in a delay in diagnosis and treatment, which in turn leads to permanent loss of renal function. We present two cases of acute kidney infarction that were initially treated as renal colic. In addition, we present a third case when ...

  9. Renal imaging in paediatrics

    International Nuclear Information System (INIS)

    The most frequent renal diseases in paediatrics include urinary tract infections, hydronephrosis, kidney anomalies and reflux. The main reason for performing DMSA scintigraphy in paediatrics is the detection of cortical abnormalities related to urinary tract infection. Because the amount of tracer retained in the tubular cells is associated with the distribution of functioning renal parenchyma in the kidney, it is possible, to evaluate the split renal function. In comparison to ultrasound and intravenous urography the sensitivity in the detection of acute as well as chronic inflammatory changes is very high, however less specific. An indication for a renography in neonates and children is beside an estimation of the total renal function and the calculation of the split renal function, the assessment of renal drainage in patients with unclear dilatation of the collecting system in ultrasound. The analysis of the time activity curve provides, especially for follow-up studies, a reproducible method to assess the urinary outflow. The diuretic scintigraphy allows the detection of urinary obstruction. Subsequently it is possible to image the micturition phase to detect vesico-ureteric reflux (indirect MCU) after drainage of tracer from the renal pelvis. An reflux in the ureters or the pelvicalyceal system is visible on the scintigraphic images and can be confirmed by time activity curves. A more invasive technique is the direct isotope cystography with bladder catheterization. The present paper should give an overview about the role of nuclear medicine in paediatric urology. (orig.)

  10. Perioperative acute renal failure.

    LENUS (Irish Health Repository)

    Mahon, Padraig

    2012-02-03

    PURPOSE OF REVIEW: Recent biochemical evidence increasingly implicates inflammatory mechanisms as precipitants of acute renal failure. In this review, we detail some of these pathways together with potential new therapeutic targets. RECENT FINDINGS: Neutrophil gelatinase-associated lipocalin appears to be a sensitive, specific and reliable biomarker of renal injury, which may be predictive of renal outcome in the perioperative setting. For estimation of glomerular filtration rate, cystatin C is superior to creatinine. No drug is definitively effective at preventing postoperative renal failure. Clinical trials of fenoldopam and atrial natriuretic peptide are, at best, equivocal. As with pharmacological preconditioning of the heart, volatile anaesthetic agents appear to offer a protective effect to the subsequently ischaemic kidney. SUMMARY: Although a greatly improved understanding of the pathophysiology of acute renal failure has offered even more therapeutic targets, the maintenance of intravascular euvolaemia and perfusion pressure is most effective at preventing new postoperative acute renal failure. In the future, strategies targeting renal regeneration after injury will use bone marrow-derived stem cells and growth factors such as insulin-like growth factor-1.

  11. Renal autotransplantation: current perspectives.

    Science.gov (United States)

    Stewart, B H; Banowsky, L H; Hewitt, C B; Straffon, R A

    1976-01-01

    Autotransplantation, with or without an extracorporeal renal operation, has been done 39 times in 37 patients. Indications for the procedure included severe ureteral injury in 4 patients, failed supravesical diversion in 2, renal carcinoma in a solitary kidney in 1, renovascular hypertension in 1 and donor arterial reconstruction before renal transplantation in 29. Success was obtained in all but 2 procedures, both of which involved previously operated kidneys with severe inflammation and adhesions involving the renal pelvis and pedicle. Based on our experience and a review of currently available literature we believe that renal autotransplantation and extracorporeal reconstruction can provide the best solution for patients with severe renovascular and ureteral disease not correctable by conventional operative techniques. The technique can be of particular value in removing centrally located tumors in solitary kidneys and in preparing donor kidneys with abnormal arteries for renal transplantation. The role of autotransplantation in the management of advanced renal trauma and calculus disease is less clear. A long-term comparison of patients treated by extracorporeal nephrolithotomy versus conventional lithotomy techniques will be necessary before a conclusion is reached in these disease categories.

  12. Renal (Kidney) Manifestations in TSC

    Medline Plus

    Full Text Available ... in TSC: renal cysts, renal angiomyolipoma and renal cell carcinoma . Renal angiomyolipomata, or angiomyolipomas, are usually the greatest concern in TSC. The blood vessels within angiomyolipomas are abnormal and can develop weak spots in their wall, called aneurysms, that can burst and lead to ...

  13. Midterm renal functions following acute renal infarction.

    Science.gov (United States)

    Ongun, Sakir; Bozkurt, Ozan; Demir, Omer; Cimen, Sertac; Aslan, Guven

    2015-10-01

    The aim of this study was to explore clinical features of renal infarction (RI) that may have a role in diagnosis and treatment in our patient cohort and provide data on midterm renal functions. Medical records of patients with diagnosis of acute RI, established by contrast enhanced computed tomography (CT) and at least 1 year follow-up data, who were hospitalized in our clinic between 1998 and 2012 were retrospectively reviewed; including descriptive data, clinical signs and symptoms, etiologic factors, laboratory findings, and prescribed treatments. Patients with solitary infarct were treated with acetylsalicylic acid (ASA) only, whereas patients with atrial fibrillation (AF) or multiple or global infarct were treated with anticoagulants. Estimated Glomerular Filtration Rate (eGFR) referring to renal functions was determined by the Modification of Diet in Renal Disease (MDRD) formula. Twenty-seven renal units of 23 patients with acute RI were identified. The mean age was 59.7 ± 15.7 years. Fourteen patients (60.8%) with RI had atrial fibrillation (AF) as an etiologic factor of which four had concomitant mesenteric ischemia at diagnosis. At presentation, 20 patients (86.9%) had elevated serum lactate dehydrogenase (LDH), 18 patients (78.2%) had leukocytosis, and 16 patients (69.5%) had microscopic hematuria. Two patients with concomitant mesenteric ischemia and AF passed away during follow up. Mean eGFR was 70.8 ± 23.2 mL/min/1.73 m(2) at admission and increased to 82.3 ± 23.4 mL/min/1.73 m(2) at 1 year follow up. RI should be considered in patients with persistent flank or abdominal pain, particularly if they are at high risk of thromboembolism. Antiplatelet and/or anticoagulant drugs are both effective treatment options according to the amplitude of the infarct for preserving kidney functions.

  14. Gentamicin Nephrotoxicity in Subclinical Renal Disease.

    Science.gov (United States)

    Frazier, Donita L.

    The purpose of the present study was to examine the pharmacokinetic disposition of gentamicin and to define the mechanisms which predispose to nephrotoxicity in subclinical renal disease. Subtotally nephrectomized beagle dogs were used as a model for human beings with compromised renal function secondary to a reduced number of functional nephrons. Using ultrastructural morphometry, light microscopy and clinical chemistry data, the model was defined and the nephrotoxic responses of intact dogs administered recommended doses of drug were compared to the response of subtotally nephrectomized dogs administered reduced doses based on each animal's clearance of drug. Lysosomal and mitochondrial morphometric changes suggested mechanisms for increased sensitivity. To determine if increased sensitivity in this model was dependent on altered serum concentrations, variable rate infusions based on individual pharmacokinetic disposition of drug were administered using computer-driven infusion pumps. Identical serum concentration-time profiles were achieved in normal dogs and subtotally nephrectomized dogs, however, toxicity was significantly greater in nephrectomized dogs. The difference in the nephrotoxic response was characterized by administering supratherapeutic doses of drug to dogs. Nephrectomized dogs given a recommended dose of gentamicin became oliguric during the second week of treatment and increasingly uremic after withdrawal of drug. In contrast, intact dogs administered 2 times the recommended dose of gentamicin become only slightly polyuric during week 4 of treatment. The need to individualize dosage regimens based on drug clearance and not serum creatinine nor creatinine clearance alone was substantiated by describing the pharmacokinetic disposition of gentamicin in spontaneously occurring disease states. Four individualized dosage regimens with differing predicted efficacy were then administered to nephrectomized dogs to determine their relative nephrotoxic

  15. Insuficiencia renal aguda

    OpenAIRE

    Carlos Hernán Mejía

    1985-01-01

    La insuficiencia renal aguda se diagnostica aproximadamente en 5% de los pacientes hospitalizados. Sus principales causas se relacionan con la alteración del flujo sanguíneo renal, sea por depleción de volumen, baja perfusión renal o por distribución intrarrenal inadecuada y obstrucción del árbol urinario. El diagnóstico parte de la historia clínica y un buen examen físico que corrobore el estado de volemia del paciente y se complementa con el uso adecuado de los índices urinarios (excreción ...

  16. Effects of renal function on pharmacokinetics and pharmacodynamics of lesinurad in adult volunteers

    Directory of Open Access Journals (Sweden)

    Gillen M

    2016-11-01

    Full Text Available Michael Gillen,1 Shakti Valdez,2 Dongmei Zhou,2 Bradley Kerr,2 Caroline A Lee,2 Zancong Shen2 1AstraZeneca LP, Gaithersburg, MD, 2Ardea Biosciences, Inc., San Diego, CA, USA Introduction: Lesinurad is a selective uric acid reabsorption inhibitor approved for the treatment of gout in combination with a xanthine oxidase inhibitor (XOI in patients who have not achieved target serum uric acid (sUA levels with an XOI alone. Most people with gout have chronic kidney disease. The pharmacokinetics, pharmacodynamics, and safety of lesinurad were assessed in subjects with impaired renal function. Methods: Two Phase I, multicenter, open-label, single-dose studies enrolled subjects with normal renal function (estimated creatinine clearance [eCrCl] >90 mL/min; N=12 or mild (eCrCl 60–89 mL/min; N=8, moderate (eCrCl 30–59 mL/min; N=16, or severe (eCrCl <30 mL/min; N=6 renal impairment. Subjects were given a single oral lesinurad dose of 200 mg (N=24 or 400 mg (N=18. Blood and urine samples were analyzed for plasma lesinurad concentrations and serum and urine uric acid concentrations. Safety was assessed by adverse events and laboratory data. Results: Mild, moderate, and severe renal impairment increased lesinurad plasma area under the plasma concentration–time curve by 34%, 54%–65%, and 102%, respectively. Lesinurad plasma Cmax was unaffected by renal function status. Lower renal clearance and urinary excretion of lesinurad were associated with the degree of renal impairment. The sUA-lowering effect of a single dose of lesinurad was similar between mild renal impairment and normal function, reduced in moderate impairment, and greatly diminished in severe impairment. Lesinurad increased urinary urate excretion in normal function and mild renal impairment; the increase was less with moderate or severe renal impairment. Lesinurad was well tolerated by all subjects. Conclusion: Lesinurad exposure increased with decreasing renal function; however, the

  17. Trace elements in renal disease and hemodialysis

    Science.gov (United States)

    Miura, Yoshinori; Nakai, Keiko; Suwabe, Akira; Sera, Koichiro

    2002-04-01

    A number of considerations suggest that trace element disturbances might occur in patients with renal disease and in hemodialysis (HD) patients. Using particle induced X-ray emission, we demonstrated the relations between serum concentration, urinary excretion of the trace elements and creatinine clearance (Ccr) in randomized 50 patients. To estimate the effects of HD, we also observed the changes of these elements in serum and dialysis fluids during HD. Urinary silicon excretion decreased, and serum silicon concentration increased as Ccr decreased, with significant correlation ( r=0.702, p<0.001 and r=0.676, p<0.0001, respectively). We also observed the increase of serum silicon, and the decrease of silicon in dialysis fluids during HD. These results suggested that reduced renal function and also dialysis contributed to silicon accumulation. Although serum selenium decreased significantly according to Ccr decrease ( r=0.452, p<0.01), we could detect no change in urinary selenium excretion and no transfer during HD. Serum bromine and urinary excretion of bromine did not correlate to Ccr. However we observed a bromine transfer from the serum to the dialysis fluid that contributed to the serum bromine decrease in HD patients.

  18. Effects of acute hypoxia on renal and endocrine function at rest and during graded exercise in hydrated subjects

    DEFF Research Database (Denmark)

    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...

  19. Is the new GFR equation using inulin clearance a more accurate method for Asian patients?

    Science.gov (United States)

    Kim, Beom Seok; Lee, Yong Kyu; Choi, Hoon Young; Choi, Seung Ok; Shin, Sug Kyun; Ha, Sung Kyu; Lee, Kang Wook; Kim, Yang Wook; Kim, Yong Lim; Yasuda, Yoshinari; Imai, Enyu; Horio, Masaru; Tomino, Yasuhiko; Matsuo, Seiichi; Lee, Ho Yung

    2015-12-01

    Recently, a new glomerular filtration rate (GFR) equation for the Japanese population was proposed using measured inulin clearance. To expand its applicability to other Asian populations, we performed a comparative study in the Korean population. Inulin clearance was measured in 166 patients from seven participating medical centers in Korea. Patient's sera and urine were collected, and baseline clinical characteristics were measured to provide an estimated GFR (eGFR) by the Japanese GFR equation using inulin clearance (Japanese-GFR equation), the Modification of Diet in Renal Disease (MDRD) study equation, and the Chronic Kidney Disease - Epidemiology Collaboration (CKD-EPI) equation. We compared the results to determine which equation best estimated the measured GFR (mGFR). Accuracy (95% CI) within 30% of mGFR by the Japanese-GFR equation, the CKD-EPI equation and the MDRD study equation were 66 (58 - 72), 51 (43 - 58), and 55 (47 - 62)%, respectively. Bias (mGFR minus eGFR) were 3.4 ± 22.4, -12.0 ± 22.1, and -9.7 ± 23.8 mL/min/1.73 m2, respectively. The accuracy of the Japanese-GFR equation was significantly better than MDRD study equation in subjects with mGFR < 60 mL/min/1.73 m2 and in total subjects. The bias of the Japanese-GFR equation was significantly smaller compared with other two equations in total subjects. The Japanese-GFR equation has a higher accuracy with less bias than the other equations in estimating GFR in Korean populations. Further studies are required to determine if the current Japanese-GFR equation could represent the standard eGFR for other Asian populations.

  20. The amylase-to-creatinine clearance ratio--a non-specific response to acute illness?

    Science.gov (United States)

    McMahon, M J; Playforth, M J; Rashid, S A; Cooper, E H

    1982-01-01

    It was felt that the apparent specificity of the amylase-to-creatine clearance ratio (ACCR) in several previous studies of pancreatitis might reflect a failure to utilize adequately ill control subjects. The ACCR and the renal clearances of beta 2-microglobulin (B2-m), similarly related to creatinine (BCCR) as well as the urinary concentration of albumin, were compared in 27 patients with acute pancreatitis, 8 with a perforated peptic ulcer and 7 with mild biliary colic, during the first 5 days in hospital. Acute pancreatitis was graded as mild (6), moderate (14) or severe (7), using a combination of clinical data, diagnostic peritoneal lavage and multiple criteria. Further assessment of the severity of the acute illness was obtained from measurement of C-reactive protein (C-RP). Lowest C-RP levels were found in the patients with mild pancreatitis and biliary colic, and highest levels in the patients with severe pancreatitis and perforated ulcer (P less than 0.002). Similarly, ACCR and BCCR levels were significantly lower in the two mild groups than in the two severe ones (P less than 0.01 and less than 0.002 respectively), although plasma amylase was raised only in patients with pancreatitis and plasma B2-m was similar in all groups. Electrophoresis of urine showed dense bands of tubuloprotein in patients from both severe groups. Urine albumin was higher in severe pancreatitis than in perforated ulcer (P less than 0.1), perhaps indicating a more specific glomerular lesion in pancreatitis. Thus a rise in amylase clearance appeared to be related to the severity of the acute illness, and may be a component of a non-specific tubuloproteinuria. In this study patients with a perforated peptic ulcer had increases in ACCR similar to those seen in patients with severe pancreatitis, and we are therefore doubtful whether ACCR has any role in the clinical diagnosis of pancreatic disease.

  1. The amylase-to-creatinine clearance ratio--a non-specific response to acute illness?

    Science.gov (United States)

    McMahon, M J; Playforth, M J; Rashid, S A; Cooper, E H

    1982-01-01

    It was felt that the apparent specificity of the amylase-to-creatine clearance ratio (ACCR) in several previous studies of pancreatitis might reflect a failure to utilize adequately ill control subjects. The ACCR and the renal clearances of beta 2-microglobulin (B2-m), similarly related to creatinine (BCCR) as well as the urinary concentration of albumin, were compared in 27 patients with acute pancreatitis, 8 with a perforated peptic ulcer and 7 with mild biliary colic, during the first 5 days in hospital. Acute pancreatitis was graded as mild (6), moderate (14) or severe (7), using a combination of clinical data, diagnostic peritoneal lavage and multiple criteria. Further assessment of the severity of the acute illness was obtained from measurement of C-reactive protein (C-RP). Lowest C-RP levels were found in the patients with mild pancreatitis and biliary colic, and highest levels in the patients with severe pancreatitis and perforated ulcer (P less than 0.002). Similarly, ACCR and BCCR levels were significantly lower in the two mild groups than in the two severe ones (P less than 0.01 and less than 0.002 respectively), although plasma amylase was raised only in patients with pancreatitis and plasma B2-m was similar in all groups. Electrophoresis of urine showed dense bands of tubuloprotein in patients from both severe groups. Urine albumin was higher in severe pancreatitis than in perforated ulcer (P less than 0.1), perhaps indicating a more specific glomerular lesion in pancreatitis. Thus a rise in amylase clearance appeared to be related to the severity of the acute illness, and may be a component of a non-specific tubuloproteinuria. In this study patients with a perforated peptic ulcer had increases in ACCR similar to those seen in patients with severe pancreatitis, and we are therefore doubtful whether ACCR has any role in the clinical diagnosis of pancreatic disease. PMID:6172175

  2. Loss of Lrp2 in zebrafish disrupts pronephric tubular clearance but not forebrain development.

    Science.gov (United States)

    Kur, Esther; Christa, Anna; Veth, Kerry N; Gajera, Chandresh R; Andrade-Navarro, Miguel A; Zhang, Jingjing; Willer, Jason R; Gregg, Ronald G; Abdelilah-Seyfried, Salim; Bachmann, Sebastian; Link, Brian A; Hammes, Annette; Willnow, Thomas E

    2011-06-01

    Low-density lipoprotein receptor-related protein 2 (LRP2) is a multifunctional cell surface receptor conserved from nematodes to humans. In mammals, it acts as regulator of sonic hedgehog and bone morphogenetic protein pathways in patterning of the embryonic forebrain and as a clearance receptor in the adult kidney. Little is known about activities of this LRP in other phyla. Here, we extend the functional elucidation of LRP2 to zebrafish as a model organism of receptor (dys)function. We demonstrate that expression of Lrp2 in embryonic and larval fish recapitulates the patterns seen in mammalian brain and kidney. Furthermore, we studied the consequence of receptor deficiencies in lrp2 and in lrp2b, a homologue unique to fish, using ENU mutagenesis or morpholino knockdown. While receptor-deficient zebrafish suffer from overt renal resorption deficiency, their brain development proceeds normally, suggesting evolutionary conservation of receptor functions in pronephric duct clearance but not in patterning of the teleost forebrain.

  3. Does previous open renal surgery or percutaneous nephrolithotomy affect the outcomes and complications of percutaneous nephrolithotomy.

    Science.gov (United States)

    Ozgor, Faruk; Kucuktopcu, Onur; Sarılar, Omer; Toptas, Mehmet; Simsek, Abdulmuttalip; Gurbuz, Zafer Gokhan; Akbulut, Mehmet Fatih; Muslumanoglu, Ahmet Yaser; Binbay, Murat

    2015-11-01

    In this study, we aim to evaluate the effectiveness and safety of PNL in patients with a history of open renal surgery or PNL by comparing with primary patients and to compare impact of previous open renal surgery and PNL on the success and complications of subsequent PNL. Charts of patients, who underwent PNL at our institute, were analyzed retrospectively. Patients were divided into three groups according to history of renal stone surgery. Patients without history of renal surgery were enrolled into Group 1. Other patients with previous PNL and previous open surgery were categorized as Group 2 and Group 3. Preoperative characteristic, perioperative data, stone-free status, and complication rates were compared between the groups. Stone-free status was accepted as completing clearance of stone and residual fragment smaller than 4 mm. Eventually, 2070 patients were enrolled into the study. Open renal surgery and PNL had been done in 410 (Group 2) and 131 (Group 3) patients, retrospectively. The mean operation time was longer (71.3 ± 33.5 min) in Group 2 and the mean fluoroscopy time was longer (8.6 ± 5.0) in Group 3 but there was no statistically significant difference between the groups. Highest stone clearance was achieved in primary PNL patients (81.62%) compared to the other groups (77.10% in Group 2 and 75.61% in Group 3). Stone-free rate was not significantly different between Group 2 and Group 3. Fever, pulmonary complications, and blood transfusion requirement were not statically different between groups but angioembolization was significantly higher in Group 2. Percutaneous nephrolithotomy is a safe and effective treatment modality for patients with renal stones regardless history of previous PNL or open renal surgery. However, history of open renal surgery but not PNL significantly reduced PNL success.

  4. Does previous open renal surgery or percutaneous nephrolithotomy affect the outcomes and complications of percutaneous nephrolithotomy.

    Science.gov (United States)

    Ozgor, Faruk; Kucuktopcu, Onur; Sarılar, Omer; Toptas, Mehmet; Simsek, Abdulmuttalip; Gurbuz, Zafer Gokhan; Akbulut, Mehmet Fatih; Muslumanoglu, Ahmet Yaser; Binbay, Murat

    2015-11-01

    In this study, we aim to evaluate the effectiveness and safety of PNL in patients with a history of open renal surgery or PNL by comparing with primary patients and to compare impact of previous open renal surgery and PNL on the success and complications of subsequent PNL. Charts of patients, who underwent PNL at our institute, were analyzed retrospectively. Patients were divided into three groups according to history of renal stone surgery. Patients without history of renal surgery were enrolled into Group 1. Other patients with previous PNL and previous open surgery were categorized as Group 2 and Group 3. Preoperative characteristic, perioperative data, stone-free status, and complication rates were compared between the groups. Stone-free status was accepted as completing clearance of stone and residual fragment smaller than 4 mm. Eventually, 2070 patients were enrolled into the study. Open renal surgery and PNL had been done in 410 (Group 2) and 131 (Group 3) patients, retrospectively. The mean operation time was longer (71.3 ± 33.5 min) in Group 2 and the mean fluoroscopy time was longer (8.6 ± 5.0) in Group 3 but there was no statistically significant difference between the groups. Highest stone clearance was achieved in primary PNL patients (81.62%) compared to the other groups (77.10% in Group 2 and 75.61% in Group 3). Stone-free rate was not significantly different between Group 2 and Group 3. Fever, pulmonary complications, and blood transfusion requirement were not statically different between groups but angioembolization was significantly higher in Group 2. Percutaneous nephrolithotomy is a safe and effective treatment modality for patients with renal stones regardless history of previous PNL or open renal surgery. However, history of open renal surgery but not PNL significantly reduced PNL success. PMID:26141983

  5. Allometric scaling for predicting human clearance of bisphenol A

    Energy Technology Data Exchange (ETDEWEB)

    Collet, Séverine H., E-mail: s.collet@envt.fr; Picard-Hagen, Nicole, E-mail: n.hagen-picard@envt.fr; Lacroix, Marlène Z., E-mail: m.lacroix@envt.fr; Puel, Sylvie, E-mail: s.puel@envt.fr; Viguié, Catherine, E-mail: c.viguie@envt.fr; Bousquet-Melou, Alain, E-mail: a.bousquet-Melou@envt.fr; Toutain, Pierre-Louis, E-mail: pltoutain@wanadoo.fr; Gayrard, Véronique, E-mail: v.gayrard@envt.fr

    2015-05-01

    The investigation of interspecies differences in bisphenol A (BPA) pharmacokinetics (PK) may be useful for translating findings from animal studies to humans, identifying major processes involved in BPA clearance mechanisms, and predicting BPA PK parameters in man. For the first time, a large range of species in terms of body weight, from 0.02 kg (mice) to 495 kg (horses) was used to predict BPA clearance in man by an allometric approach. BPA PK was evaluated after intravenous administration of BPA in horses, sheep, pigs, dogs, rats and mice. A non-compartmental analysis was used to estimate plasma clearance and steady state volume of distribution and predict BPA PK parameters in humans from allometric scaling. In all the species investigated, BPA plasma clearance was high and of the same order of magnitude as their respective hepatic blood flow. By an allometric scaling, the human clearance was estimated to be 1.79 L/min (equivalent to 25.6 mL/kg.min) with a 95% prediction interval of 0.36 to 8.83 L/min. Our results support the hypothesis that there are highly efficient and hepatic mechanisms of BPA clearance in man. - Highlights: • Allometric scaling was used to predict BPA pharmacokinetic parameters in humans. • In all species, BPA plasma clearance approached hepatic blood flow. • Human BPA clearance was estimated to be 1.79 L/min.

  6. Clearance systems in the brain-implications for Alzheimer disease.

    Science.gov (United States)

    Tarasoff-Conway, Jenna M; Carare, Roxana O; Osorio, Ricardo S; Glodzik, Lidia; Butler, Tracy; Fieremans, Els; Axel, Leon; Rusinek, Henry; Nicholson, Charles; Zlokovic, Berislav V; Frangione, Blas; Blennow, Kaj; Ménard, Joël; Zetterberg, Henrik; Wisniewski, Thomas; de Leon, Mony J

    2015-08-01

    Accumulation of toxic protein aggregates-amyloid-β (Aβ) plaques and hyperphosphorylated tau tangles-is the pathological hallmark of Alzheimer disease (AD). Aβ accumulation has been hypothesized to result from an imbalance between Aβ production and clearance; indeed, Aβ clearance seems to be impaired in both early and late forms of AD. To develop efficient strategies to slow down or halt AD, it is critical to understand how Aβ is cleared from the brain. Extracellular Aβ deposits can be removed from the brain by various clearance systems, most importantly, transport across the blood-brain barrier. Findings from the past few years suggest that astroglial-mediated interstitial fluid (ISF) bulk flow, known as the glymphatic system, might contribute to a larger portion of extracellular Aβ (eAβ) clearance than previously thought. The meningeal lymphatic vessels, discovered in 2015, might provide another clearance route. Because these clearance systems act together to drive eAβ from the brain, any alteration to their function could contribute to AD. An understanding of Aβ clearance might provide strategies to reduce excess Aβ deposits and delay, or even prevent, disease onset. In this Review, we describe the clearance systems of the brain as they relate to proteins implicated in AD pathology, with the main focus on Aβ. PMID:26195256

  7. Do dialysate conductivity measurements provide conductivity clearance or ionic dialysance?

    Science.gov (United States)

    Petitclerc, T

    2006-11-01

    Dialysate conductivity measurements allow on-line estimation of urea clearance during hemodialysis session. Conductivity measurements provide a value of 'conductivity clearance' for some authors, but a value of 'ionic dialysance' for others. This paper aims at explaining which term should be the more appropriate. Clearance is a parameter defined for measuring the power of a mechanism, which aims at 'clearing' a solution by depurating some solutes. In hemodialysis, clearance measures the efficacy of patient's depuration. In contrast, dialysance measures the capability of transferring solutes between blood and dialysate. The conventional definition of dialysance, requiring the absence of convective transfer, should be generalized to the case of the usual presence of ultrafiltration during the hemodialysis session. For a solute (as urea) absent from the dialysate delivered to the dialyzer inlet, the clearance is equal to its dialysance. In order to avoid a dramatic fall in ionic concentrations during hemodialysis treatment, the clearance of ions is reduced by adding these ions in the dialysate and becomes lower than their dialysance. Conductivity measurements provide a value of electrolytes dialysance. Thus the term of 'ionic dialysance' is more appropriate than the term of 'conductivity clearance'. Nevertheless ionic dialysance represents a good estimation of urea clearance.

  8. Radioaerosol delivery and clearance in patients with respiratory failure

    International Nuclear Information System (INIS)

    A technique for radioaerosol delivery to patients requiring mechanical ventilation is described. Ventilation images and pulmonary radioaerosol clearance rates were successfully obtained in 35 patients regardless of ventilator type or level of positive end-expiratory pressure (PEEP). Those patients with noncardiogenic pulmonary edema (NPE) had significantly increased clearance rates relative to those patients in whom NPE was not present

  9. 48 CFR 32.502-2 - Contract finance office clearance.

    Science.gov (United States)

    2010-10-01

    ... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Contract finance office clearance. 32.502-2 Section 32.502-2 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION... finance office clearance. The contracting officer shall obtain the approval of the contract finance...

  10. 48 CFR 1432.502-2 - Contract finance office clearance.

    Science.gov (United States)

    2010-10-01

    ... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Contract finance office clearance. 1432.502-2 Section 1432.502-2 Federal Acquisition Regulations System DEPARTMENT OF THE INTERIOR... finance office clearance. The CO shall obtain approval of the bureau finance office prior to...

  11. 48 CFR 832.502-2 - Contract finance office clearance.

    Science.gov (United States)

    2010-10-01

    ... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Contract finance office clearance. 832.502-2 Section 832.502-2 Federal Acquisition Regulations System DEPARTMENT OF VETERANS AFFAIRS... finance office clearance. Contracting officers must obtain approval from the DSPE before taking...

  12. 32 CFR 644.522 - Clearance of military scrap.

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 4 2010-07-01 2010-07-01 true Clearance of military scrap. 644.522 Section 644... Excess Land and Improvements § 644.522 Clearance of military scrap. Military scrap can contain or be... determining whether scrap metal will be removed should be the safety of persons coming on the land in...

  13. 14 CFR 29.411 - Ground clearance: tail rotor guard.

    Science.gov (United States)

    2010-01-01

    ... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Ground clearance: tail rotor guard. 29.411... System Loads § 29.411 Ground clearance: tail rotor guard. (a) It must be impossible for the tail rotor to contact the landing surface during a normal landing. (b) If a tail rotor guard is required to...

  14. 14 CFR 27.411 - Ground clearance: tail rotor guard.

    Science.gov (United States)

    2010-01-01

    ... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Ground clearance: tail rotor guard. 27.411... System Loads § 27.411 Ground clearance: tail rotor guard. (a) It must be impossible for the tail rotor to contact the landing surface during a normal landing. (b) If a tail rotor guard is required to...

  15. Benefits of Improved HP Turbine Active Clearance Control

    Science.gov (United States)

    Ruiz, Rafael; Albers, Bob; Sak, Wojciech; Seitzer, Ken; Steinetz, Bruce M.

    2007-01-01

    As part of the NASA Propulsion 21 program, GE Aircraft Engines was contracted to develop an improved high pressure turbine(HPT) active clearance control (ACC) system. The system is envisioned to minimize blade tip clearances to improve HPT efficiency throughout the engine operation range simultaneously reducing fuel consumption and emissions.

  16. Allometric scaling for predicting human clearance of bisphenol A

    International Nuclear Information System (INIS)

    The investigation of interspecies differences in bisphenol A (BPA) pharmacokinetics (PK) may be useful for translating findings from animal studies to humans, identifying major processes involved in BPA clearance mechanisms, and predicting BPA PK parameters in man. For the first time, a large range of species in terms of body weight, from 0.02 kg (mice) to 495 kg (horses) was used to predict BPA clearance in man by an allometric approach. BPA PK was evaluated after intravenous administration of BPA in horses, sheep, pigs, dogs, rats and mice. A non-compartmental analysis was used to estimate plasma clearance and steady state volume of distribution and predict BPA PK parameters in humans from allometric scaling. In all the species investigated, BPA plasma clearance was high and of the same order of magnitude as their respective hepatic blood flow. By an allometric scaling, the human clearance was estimated to be 1.79 L/min (equivalent to 25.6 mL/kg.min) with a 95% prediction interval of 0.36 to 8.83 L/min. Our results support the hypothesis that there are highly efficient and hepatic mechanisms of BPA clearance in man. - Highlights: • Allometric scaling was used to predict BPA pharmacokinetic parameters in humans. • In all species, BPA plasma clearance approached hepatic blood flow. • Human BPA clearance was estimated to be 1.79 L/min

  17. Study of global operational needs for mine clearance equipment

    Science.gov (United States)

    Blagden, Paddy M.

    2003-09-01

    The Geneva International Centre for Humanitarian Demining studied the needs of landmine clearance groups for equipment to carry out specific functions of mine clearance. This was done on a global level, and useful results were obtained, which will provide the basis for further analysis.

  18. Renal scintigraphy in veterinary medicine.

    Science.gov (United States)

    Tyson, Reid; Daniel, Gregory B

    2014-01-01

    Renal scintigraphy is performed commonly in dogs and cats and has been used in a variety of other species. In a 2012 survey of the members of the Society of Veterinary Nuclear Medicine, 95% of the respondents indicated they perform renal scintigraphy in their practice. Renal scintigraphy is primarily used to assess renal function and to evaluate postrenal obstruction. This article reviews how renal scintigraphy is used in veterinary medicine and describes the methods of analysis. Species variation is also discussed.

  19. Renal effects of hyperinsulinaemia in subjects with two hypertensive parents

    DEFF Research Database (Denmark)

    Andersen, U B; Skøtt, P; Bruun, N E;

    1999-01-01

    aged 18-35 years whose parents both had essential hypertension, and 22 age- and sex-matched subjects whose parents were both normotensive. Diabetes or morbid obesity in any subject or parent excluded the family. The 24-h blood pressure was measured. The subjects received an isocaloric diet with a fixed......The aim of this investigation was to study the effects of isoglycaemic hyperinsulinaemia on the renal metabolism of electrolytes and water in subjects with a strong genetic predisposition to essential hypertension, compared with that in non-predisposed subjects. We studied 25 normotensive subjects...... and during hyperinsulinaemia. In response to hyperinsulinaemia, renal sodium clearance decreased to a significantly greater extent in the hypertension-prone subjects [0.57 (0.74, 0.36) ml.min(-1).1.73 m(2) (median and quartiles)] than in the controls [0.34 (0.56, 0.18) ml. min(-1).1.73 m(2)] (P=0...

  20. Predicting clearance in humans from in vitro data.

    Science.gov (United States)

    Obach, R Scott

    2011-01-01

    The use of in vitro metabolism in scaling to predict human clearance of new chemical entities has become a commonplace activity in the research and development of new drugs. The measurement of in vitro lability in human liver microsomes, a rich source of drug metabolizing cytochrome P450 enzymes, has become a high throughput screen in many research organizations which is a testament to its usefulness in drug design. In this chapter, the methods used to scale in vitro clearance data to predict in vivo clearance are described. Importantly, the numerous assumptions that are required in order to use in vitro data in this manner are laid out. These include assumptions regarding the scaling process as well as technical aspects of the generation of the in vitro data. Finally, some other drug clearance processes that have been emerging as important are described with regard to ongoing research efforts to develop clearance prediction methods.

  1. Servo-control of water and sodium homeostasis during renal clearance measurements in conscious rats

    DEFF Research Database (Denmark)

    Thomsen, Klaus; Shirley, David G

    2007-01-01

    of a suitably high urine flow rate by constant infusion of hypotonic glucose solution. The second series of experiments showed that replacement of blood samples with donor blood can also lead to increases in fractional lithium excretion and accompanying increases in water and sodium excretion, a problem...

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

    Directory of Open Access Journals (Sweden)

    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.

  3. [Effects of repeated sevoflurane anesthesia on hepatic and renal function in a pediatric patient].

    Science.gov (United States)

    Tanikawa, M; Mitsuhata, H; Shimizu, R; Akazawa, S; Fukuda, H; Saitoh, K; Hirabayashi, Y; Togashi, H

    1994-10-01

    A 10-yr-old boy with an injured lower extremity received sevoflurane anesthesia 5 times within 40 days. Laboratory tests for hepatic and renal function i.e., serum transaminase (glutamic oxaloacetic transaminase, glutamic pyruvic transaminase, gamma-glutamyl transpeptidase), serum cholinesterase, plasma protein, serum cholinesterase, serum bilirubine, serum lactic dehydrogenase, serum prothrombin time, blood urea nitrogen, serum creatinine, beta 2-microglobulin, N-acetyl-D-glucosamidase and 24 hr-creatinine clearance remained within normal ranges throughout his perioperative period. Repeated sevoflurane anesthesia did not exert any adverse effect on hepatic and renal function in this patient.

  4. Lipoprotein X Causes Renal Disease in LCAT Deficiency.

    Directory of Open Access Journals (Sweden)

    Alice Ossoli

    Full Text Available Human familial lecithin:cholesterol acyltransferase (LCAT deficiency (FLD is characterized by low HDL, accumulation of an abnormal cholesterol-rich multilamellar particle called lipoprotein-X (LpX in plasma, and renal disease. The aim of our study was to determine if LpX is nephrotoxic and to gain insight into the pathogenesis of FLD renal disease. We administered a synthetic LpX, nearly identical to endogenous LpX in its physical, chemical and biologic characteristics, to wild-type and Lcat-/- mice. Our in vitro and in vivo studies demonstrated an apoA-I and LCAT-dependent pathway for LpX conversion to HDL-like particles, which likely mediates normal plasma clearance of LpX. Plasma clearance of exogenous LpX was markedly delayed in Lcat-/- mice, which have low HDL, but only minimal amounts of endogenous LpX and do not spontaneously develop renal disease. Chronically administered exogenous LpX deposited in all renal glomerular cellular and matrical compartments of Lcat-/- mice, and induced proteinuria and nephrotoxic gene changes, as well as all of the hallmarks of FLD renal disease as assessed by histological, TEM, and SEM analyses. Extensive in vivo EM studies revealed LpX uptake by macropinocytosis into mouse glomerular endothelial cells, podocytes, and mesangial cells and delivery to lysosomes where it was degraded. Endocytosed LpX appeared to be degraded by both human podocyte and mesangial cell lysosomal PLA2 and induced podocyte secretion of pro-inflammatory IL-6 in vitro and renal Cxl10 expression in Lcat-/- mice. In conclusion, LpX is a nephrotoxic particle that in the absence of Lcat induces all of the histological and functional hallmarks of FLD and hence may serve as a biomarker for monitoring recombinant LCAT therapy. In addition, our studies suggest that LpX-induced loss of endothelial barrier function and release of cytokines by renal glomerular cells likely plays a role in the initiation and progression of FLD nephrosis.

  5. Complete renal recovery from severe acute renal failure after thrombolysis of bilateral renal vein thrombosis.

    Science.gov (United States)

    Ramadoss, Suresh; Jones, Robert G; Foggensteiner, Lukas; Willis, Andrew P; Duddy, Martin J

    2012-10-01

    A previously healthy young man presented with acute renal failure due to extensive spontaneous deep vein thrombosis, including the inferior vena cava (IVC) and both renal veins. The patient was treated with selectively delivered thrombolytic therapy over a 7-day-period, which resulted in renal vein patency and complete recovery of renal function. A stent was placed over a segment stenosis of the IVC. No thrombophilic factors were identified. Bilateral renal vein thrombosis in young fit individuals is an unusual cause of acute renal failure. Thrombolytic therapy, even with delay, can completely restore renal function.

  6. Primary renal synovial sarcoma

    Directory of Open Access Journals (Sweden)

    Girish D. Bakhshi

    2012-03-01

    Full Text Available Primary Renal Sarcoma is rare tumor comprising only 1% of all renal tumours. Synovial sarcomas are generally deep-seated tumors arising in the proximity of large joints of adolescents and young adults and account for 5-10% of all soft tissue tumours. Primary synovial sarcoma of kidney is rare and has poor prognosis. It can only be diagnosed by immunohistochemistry. It should be considered as a differential in sarcomatoid and spindle cell tumours. We present a case of 33-year-old female, who underwent left sided radical nephrectomy for renal tumour. Histopathology and genetic analysis diagnosed it to be primary renal synovial sarcoma. Patient underwent radiation therapy and 2 years follow up is uneventful. A brief case report with review of literature is presented.

  7. Dopamins renale virkninger

    DEFF Research Database (Denmark)

    Olsen, Niels Vidiendal

    1990-01-01

    is closely associated with the renal treatment of water and salt but the mechanism is not yet elucidated. In low doses (1-5 micrograms/kg/min), dopamine increases renal blood flow (RBF) and the glomerular filtration rate (GFR). In addition, pronounced diuretic and natriuretic effects are observed which...... are possible not exclusively secondary to alterations in the renal haemodynamics but may also be due to specific tubular effects. Recent investigations have revealed that dopamine does not increase RBF and GFR in patients with chronic renal failure if GFR is less than 60 ml/minute. Dopamine in low doses...... dialysis unnecessary in a number of patients on account of increased diuresis and natriuresis. The effect of GFR and the significance for the prognosis are not known....

  8. Analysis of conservativity analysis for clearance levels. Final report

    International Nuclear Information System (INIS)

    When deriving clearance levels for material from nuclear installations it is necessary to proceed with a certain degree of conservativity. This can, however, differ between various sets of clearance levels leading to inconsistencies between clearance pathways. The aim of the work therefore is to compare levels of conservativity for the following two sets of clearance levels: clearance levels for disposal as conventional waste and for metallic materials for recycling/reuse. A method was developed to quantify the degree of conservativity and make it comparable. The actual and future situation for disposal of (conventional) wastes in Germany was analysed. In addition, the masses, nuclide vectors, geographical distribution etc. for slightly radioactive material being cleared for conventional disposal was analysed and modelled and the resulting dose distributions were calculated. The values for the clearance levels were taken from the 1995 recommendation by the German Commission on Radiation Protection (SSK). By using realistic scenarios, the exposure was calculated for the personnel on the landfills and for persons of the general public being exposed via groundwater pathways. It could be shown that the trivial dose range will not be exceeded even if the masses of cleared material per landfill site exceed 100 Mg/a. Because of the types and distribution of nuclear installations in Germany and because of the nuclide vectors it is therefore not necessary to limit the masses per landfill sites. Clearance levels that are determined by the exposure pathways external exposure to and the inhalation of dust by the landfill personnel show a similar level of conservativity as those for metal scrap. This means that the clearance levels for gamma emitting nuclides are not overly restrictive. Although radiologically justified, raising the clearance levels would not lead to an increase of the material quantities because other nuclides of the respective nuclide vectors are limiting. In

  9. Quantitative urinary protein excretion in chronic renal failure.

    Science.gov (United States)

    McMorrow, R G; Galla, J H; Luke, R G

    1982-01-01

    The diagnostic value of the measurement of quantitative proteinuria in patients with a creatinine clearance of less than 10 ml/min was determined in patients seen in a single center over a 5-year period. All 126 patients in whom a definitive renal diagnosis was possible were included. Patients with glomerular disease excreted 6.1 +/- 0.6 g/day and patients with interstitial disease 1.5 +/- 0.3 g/day (p less than 0.001). In individual patients with end-stage renal disease, however, measurement of urinary protein excretion excluded (with 95% confidence levels) patients with interstitial diseases only when greater than 2.9 g/day. To examine the natural history of proteinuria in progressive renal disease, urinary protein, absolute and factored for glomerular filtration rate (GFR; creatinine clearance), was determined at 10 ml/min decrements in GFR for patients with membranoproliferative glomerulonephritis, idiopathic membranous glomerulonephritis and focal glomerulosclerosis. Quantitative urinary protein excretion was relatively constant as GFR fell but did fall significantly at less than 10 ml/min but only to 4.8-7.0 g/day at even that level. Urinary protein excretion/GFR increased as GFR fell, particularly at end stage where a highly significant four-fold rise was seen; an increase also occurred in patients with primary interstitial disease. Similar data were obtained for 34 randomly selected patients after at least 1 year of chronic hemodialysis. Although a significant decline in absolute urinary protein excretion occurred during the year of dialysis to levels not different between glomerular and interstitial disease, urinary protein excretion/unit GFR remained elevated. Increased urinary protein excretion/unit GFR may result from a functional adaptation of remaining nephrons in response to declining renal mass.

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

    Science.gov (United States)

    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. [Hyperuricemia and renal risk].

    Science.gov (United States)

    Viazzi, Francesca; Bonino, Barbara; Ratto, Elena; Desideri, Giovambattista; Pontremoli, Roberto

    2015-01-01

    Recent studies have revealed an association between elevated levels of uric acid and conditions correlated to chronic kidney diseases such as hypertension, cardiovascular and cerebral disease, insulin resistance. Several pathogenetic mechanisms at cellular and tissue levels could justify a direct correlation between serum uric acid levels and renal damage. Growing evidence indicating a correlation between urate lowering therapy and renal morbidity could encourage the use of urate lowering therapy in primary or secondary prevention in chronic kidney disease.

  12. Retroperitoneal laparoscopic pyelolithotomy versus extra corporeal shock-wave lithotripsy for management of renal stones

    Directory of Open Access Journals (Sweden)

    Chander Jagdish

    2010-01-01

    Full Text Available Aim: The purpose of this study was to evaluate the role of retroperitoneal laparoscopic pyelolithotomy (RPPL and its comparison with extra corporeal shock wave lithotripsy in the management of renal calculi. Materials and Methods: The study was carried out in the Department of surgery, Maulana Azad Medical College, New Delhi, India. The study included 86 cases of solitary renal calculi in the retroperitoneoscopic (RPPL group and 82 cases in the shock wave lithotripsy (SWL group. The parameters compared were stone clearance, hospital stay, number of postoperative visits, mean time to resume normal activities, number of man days lost, and analgesic requirement. Results : The RPPL group showed better stone clearance, fewer hospital visits, low analgesic requirement, fewer number of man days lost, and early resumption of normal activities, as compared to the SWL group. Conclusions : Shock wave lithotripsy, being a noninvasive modality, is an established procedure all over the world. However RPPL achieves comparable or better results in high volume centers.

  13. Renal dysplasia: US findings

    Energy Technology Data Exchange (ETDEWEB)

    Ha, Doo Hoe; Oh, Ki Keun; Jung, Woo Hee; Yoon, Choon Sik; Ahn, Chang Soo; Kim, Myung Joon [Yonsei University College of Medicine, Seoul (Korea, Republic of)

    1993-12-15

    Renal dysplasia is a congenital anomaly with abnormal development of nephrotic and ductal structure and untreatable disease with absent renal function. To determine whether any consistent sonographic patterns exists,the sonograms of 27 pediatric patients with mastocytosis despotically kidney were reviewed. The diagnosis was proved by pathology in 16 cases and other radiologic imaging in 11 cases. In the classical multicystic despotically kidney(pelvoinfundibular atresia type, 10 cases), there were typical findings, such as absent communication between peripherally located variable sized cysts and presence of the largest cyst away from the renal hilum. One case was associated contralateral renal hydronephrosis. There cases were hydro nephrotic type which had medial location of the largest cyst with non communicating peripheral cysts. Segmental dysplasia with double collecting system and ureterocele (5 cases) and dysplasia due to parasite urethral valve (2 cases) showed hydronephrosis without identifiable peripheral cysts. Among the hypoplastic dysplastic kidney (7 cases) including ectopic kidneys (3cases), corticomedullary differentiation were hard to be identified in 2 cases. In conclusion, diagnosis of the renal dysplasia can be obtained by US only or US with other functional studies such as radionuclide scan(99mTc-DMSA or renogram) and IVP. US detection of renal dysplasia is easy, and US findings provide valuable information in the subsequent management

  14. Neonatal renal vein thrombosis.

    Science.gov (United States)

    Brandão, Leonardo R; Simpson, Ewurabena A; Lau, Keith K

    2011-12-01

    Neonatal renal vein thrombosis (RVT) continues to pose significant challenges for pediatric hematologists and nephrologists. The precise mechanism for the onset and propagation of renal thrombosis within the neonatal population is unclear, but there is suggestion that acquired and/or inherited thrombophilia traits may increase the risk for renal thromboembolic disease during the newborn period. This review summarizes the most recent studies of neonatal RVT, examining its most common features, the prevalence of acquired and inherited prothrombotic risk factors among these patients, and evaluates their short and long term renal and thrombotic outcomes as they may relate to these risk factors. Although there is some consensus regarding the management of neonatal RVT, the most recent antithrombotic therapy guidelines for the management of childhood thrombosis do not provide a risk-based algorithm for the acute management of RVT among newborns with hereditary prothrombotic disorders. Whereas neonatal RVT is not a condition associated with a high mortality rate, it is associated with significant morbidity due to renal impairment. Recent evidence to evaluate the effects of heparin-based anticoagulation and thrombolytic therapy on the long term renal function of these patients has yielded conflicting results. Long term cohort studies and randomized trials may be helpful to clarify the impact of acute versus prolonged antithrombotic therapy for reducing the morbidity that is associated with neonatal RVT.

  15. Nuclear regulation. NRC's security clearance program can be strengthened

    International Nuclear Information System (INIS)

    Because of the national security implications of its programs, the Nuclear Regulatory Commission (NRC) investigates the background of its employees and consultants as well as others to ensure that they are reliable and trustworthy. If the investigation indicates that an employee will not endanger national security, NRC grants a security clearance that allows access to classified information, material, and facilities. NRC also requires periodic checks for some clearance holders to ensure their continued clearance eligibility. The Chairman, Subcommittee on Environment, Energy, and Natural Resources, House Committee on Government Operations, asked GAO to review NRC's personnel security clearance program and assess the procedures that NRC uses to ensure that those who operate nuclear power plants do not pose a threat to the public. The Atomic Energy Act of 1954 requires NRC to conduct background investigations of its employees and consultants as well as others who have access to classified information, material, or facilities. To do this, NRC established a personnel security clearance program. Under NRC policies, a security clearance is granted after the Office of Personnel Management (OPM) or the Federal Bureau of Investigation checks the background of those applying for an NRC clearance. NRC also periodically reassesses the integrity of those holding the highest level clearance. NRC employees, consultants, contractors, and licensees as well as other federal employees hold approximately 10,600 NRC clearances. NRC does not grant clearances to commercial nuclear utility employees unless they require access to classified information or special nuclear material. However, the utilities have voluntarily established screening programs to ensure that their employees do not pose a threat to nuclear plants. NRC faces a dilemma when it hires new employees. Although its policy calls for new hires to be cleared before they start work, the security clearance process takes so long

  16. Hyporeninemic hypoaldosteronism in diabetic patients with chronic renal failure.

    Science.gov (United States)

    Grande Villoria, J; Macias Nunez, J F; Miralles, J M; De Castro del Pozo, S; Tabernero Romo, J M

    1988-01-01

    Plasma renin activity, plasma aldosterone levels and renal tubular capacity to excrete hydrogen ions were studied in 13 patients suffering from diabetes mellitus with a creatinine clearance of less than 40 ml/min. The results were compared with those obtained in a control group, in a group of nondiabetic subjects with chronic renal failure (CRF) and in a group of diabetic patients without CRF. Twelve of the thirteen diabetic patients with CRF had data characteristic of hyporeninemic hypoaldosteronism associated with type IV renal tubular acidosis. On comparing the results with those of the other two groups of patients, it was observed that the manifestations of the latter two groups considered separately were different from those of the problem group, although in the diabetic patients with normal glomerular filtration rate (GFR) hyporeninism but not hypoaldosteronism was present accompanied by a lower net acid excretion (p less than 0.001) due to a lower excretion of NH4 (p less than 0.05) and titratable acid (p less than 0.001) when the patients were challenged with an NH4Cl overload. We believe that a conjunction of diabetes and renal failure is necessary for the diabetic patients with a decrease in GFR to show hyporeninemic hypoaldosteronism and type IV tubular acidosis.

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

    OpenAIRE

    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. ...

  18. Pharmacological investigations of Punica granatum in glycerol-induced acute renal failure in rats

    OpenAIRE

    Amrit Pal Singh; Amteshwar Jaggi Singh; Nirmal Singh

    2011-01-01

    Objective : The present study was designed to investigate the ameliorative potential and possible mechanism of hydroalcoholic extract of flowers of P. granatum in glycerol-induced acute renal failure (ARF) in rats. Materials and Methods : The rats were subjected to rhabdomyolytic ARF by single intramuscular injection of hypertonic glycerol (50% v/v; 8 ml/kg) and the animals were sacrificed after 24 hours of glycerol injection. The plasma creatinine, blood urea nitrogen, creatinine clearance, ...

  19. Bilateral variations in renal vasculature

    Directory of Open Access Journals (Sweden)

    Gupta V

    2010-04-01

    Full Text Available Routine dissection of a 67-year-old male cadaver, revealed a complex anatomical variation of the renal vasculature.Right kidney was multilobulated measuring 11 x 5 x 3 cm, with the hilum containing three renal arteries and two renal veins. The upper renal artery arose from aorta just below origin of superior mesenteric artery, middle renal artery arose from 1 cm below the upper artery and the lower renal artery arose just below the origin of inferior mesenteric artery, respectively. Two veins drained the right kidney into inferior vena cava.Left kidney measured 10 x 6.5 x 4 cm. The hilum contained two renal arteries. The upper renal artery arose from the aorta just below the origin of superior mesenteric artery, the lower renal artery arose from aorta just below the origin of inferior mesenteric artery. There was a single vein draining the left kidney.Knowledge of the variations of renal vascular anatomy has importance in exploration and treatment of renal trauma, renal transplantation, renal artery embolization, surgery for abdominal aortic aneurysm and conservative or radical renal surgery.

  20. Renal Atrophy Secondary to Chemoradiotherapy of Abdominal Malignancies

    International Nuclear Information System (INIS)

    Purpose: To identify factors predictive of renal atrophy after chemoradiotherapy of gastrointestinal malignancies. Methods and Materials: Patients who received chemotherapy and abdominal radiotherapy (RT) between 2002 and 2008 were identified for this study evaluating change in kidney size and function after RT. Imaging and biochemical data were obtained before and after RT in 6-month intervals. Kidney size was defined by craniocaudal measurement on CT images. The primarily irradiated kidney (PK) was defined as the kidney that received the greater mean kidney dose. Receiver operating characteristic (ROC) curves were generated to predict risk for renal atrophy. Results: Of 130 patients, median age was 64 years, and 51.5% were male. Most primary disease sites were pancreas and periampullary tumors (77.7%). Median follow-up was 9.4 months. Creatinine clearance declined 20.89%, and size of the PK decreased 4.67% 1 year after completion of chemoradiation. Compensatory hypertrophy of the non-PK was not seen. Percentage volumes of the PK receiving ≥10 Gy (V10), 15 Gy (V15), and 20 Gy (V20) were significantly associated with renal atrophy 1 year after RT (p = 0.0030, 0.0029, and 0.0028, respectively). Areas under the ROC curves for V10, V15, and V20 to predict >5% decrease in PK size were 0.760, 0.760, and 0.762, respectively. Conclusions: Significant detriments in PK size and renal function were seen after abdominal RT. The V10, V15, and V20 were predictive of risk for PK atrophy 1 year after RT. Analyses suggest the association of lower-dose renal irradiation with subsequent development of renal atrophy.

  1. Effects of drugs on mucus clearance.

    Science.gov (United States)

    Houtmeyers, E; Gosselink, R; Gayan-Ramirez, G; Decramer, M

    1999-08-01

    Mucociliary clearance (MCC), the process in which airway mucus together with substances trapped within are moved out of the lungs, is an important defence mechanism of the human body. Drugs may alter this process, such that it is necessary to know the effect of the drugs on MCC. Indeed, agents stimulating MCC may be used therapeutically in respiratory medicine, especially in patients suspected of having an impairment of their mucociliary transport system. In contrast, caution should be taken with drugs depressing MCC as an undesired side-effect, independently of their therapeutic indication. Since cough clearance (CC) serves as a back-up system when MCC fails, the influence of drugs must be examined not only on MCC but also on CC. Ultimately, the clinical repercussions of alterations in mucus transport induced by drug administration must be studied. Tertiary ammonium compounds (anticholinergics), aspirin, anaesthetic agents and benzodiazepines have been shown to be capable of depressing the mucociliary transport system. Cholinergics, methylxanthines, sodium cromoglycate, hypertonic saline, saline as well as water aerosol have been shown to increase MCC. Adrenergic antagonists, guaifenesin, S-carboxymethylcysteine, sodium 2-mercapto-ethane sulphonate and frusemide have been reported not to alter the mucociliary transport significantly. Amiloride, uridine 5'-triphosphate (UTP), quaternary ammonium compounds (anticholinergics), adrenergic agonists, corticosteroids, recombinant human deoxyribonuclease (rhDNase), N-acetylcysteine, bromhexine and ambroxol have been reported either not to change or to augment MCC. Indirect data suggest that surfactant as well as antibiotics may improve the mucociliary transport system. As for the influence of drugs on CC, amiloride and rhDNase have been demonstrated to increase the effectiveness of cough. A trend towards an improved CC was noted after treatment with adrenergic agonists. The anticholinergic agent ipratropium bromide, which

  2. Analysis of viral clearance unit operations for monoclonal antibodies.

    Science.gov (United States)

    Miesegaes, George; Lute, Scott; Brorson, Kurt

    2010-06-01

    Demonstration of viral clearance is a critical step in assuring the safety of biotechnology products. We generated a viral clearance database that contains product information, unit operation process parameters, and viral clearance data from monoclonal antibody and antibody-related regulatory submissions to FDA. Here we present a broad overview of the database and resulting analyses. We report that the diversity of model viruses tested expands as products transition to late-phase. We also present averages and ranges of viral clearance results by Protein A and ion exchange chromatography steps, low pH chemical inactivation, and virus filtration, focusing on retro- and parvoviruses. For most unit operations, an average log reduction value (LRV, a measure of clearance power) for retrovirus of >4 log(10) were measured. Cases where clearance data fell outside of the anticipated range (i.e., outliers) were rationally explained. Lastly, a historical analysis did not find evidence of any improvement trend in viral clearance over time. The data collectively suggest that many unit operations in general can reliably clear viruses.

  3. Integrated Turbine Tip Clearance and Gas Turbine Engine Simulation

    Science.gov (United States)

    Chapman, Jeffryes W.; Kratz, Jonathan; Guo, Ten-Huei; Litt, Jonathan

    2016-01-01

    Gas turbine compressor and turbine blade tip clearance (i.e., the radial distance between the blade tip of an axial compressor or turbine and the containment structure) is a major contributing factor to gas path sealing, and can significantly affect engine efficiency and operational temperature. This paper details the creation of a generic but realistic high pressure turbine tip clearance model that may be used to facilitate active tip clearance control system research. This model uses a first principles approach to approximate thermal and mechanical deformations of the turbine system, taking into account the rotor, shroud, and blade tip components. Validation of the tip clearance model shows that the results are realistic and reflect values found in literature. In addition, this model has been integrated with a gas turbine engine simulation, creating a platform to explore engine performance as tip clearance is adjusted. Results from the integrated model explore the effects of tip clearance on engine operation and highlight advantages of tip clearance management.

  4. Renal Extraction and Acute Effects of Glucagon-like peptide-1 on Central and Renal Hemodynamics in Healthy Men

    DEFF Research Database (Denmark)

    Asmar, Ali; Simonsen, Lene; Asmar, Meena;

    2015-01-01

    of either GLP-1 (1.5 pmol kg-1 min-1) or saline, cardiac output was estimated non-invasively, and intra-arterial blood pressure and heart rate were measured continuously. Renal plasma flow, glomerular filtration rate, and uptake/release of hormones and ions were measured by Fick's Principle after...... % (p=0.016). Renal plasma flow and glomerular filtration rate as well as clearance of sodium and lithium were not affected by GLP-1. However, plasma renin activity decreased (p=0.037), whereas plasma levels of atrial natriuretic peptide (ANP) were unaffected. Renal extraction of intact GLP-1 was 43% (p...... catheterization of a renal vein. The subjects remained supine during the experiments. During GLP-1 infusion, the systolic blood pressure and arterial pulse pressure both increased by 5 ± 1 mm Hg (p=0.015 and p=0.002, respectively). Heart rate increased by 5 ± 1 bpm (p=0.005) and cardiac output increased by 18...

  5. Associations between proteinuria, systemic hypertension and glomerular filtration rate in dogs with renal and non-renal diseases.

    Science.gov (United States)

    Wehner, A; Hartmann, K; Hirschberger, J

    2008-02-01

    Proteinuria and systemic hypertension are well recognised risk factors in chronic renal failure (CRF). They are consequences of renal disease but also lead to a further loss of functional kidney tissue. The objectives of this study were to investigate the associations between proteinuria, systemic hypertension and glomerular filtration rate (GFR) in dogs with naturally occurring renal and non-renal diseases, and to determine whether proteinuria and hypertension were associated with shorter survival times in dogs with CRF. Measurements of exogenous creatinine plasma clearance (ECPC), urine protein:creatinine ratio (UPC), and Doppler sonographic measurements of systolic blood pressure (SBP) were made in 60 dogs with various diseases. There was a weak but significant inverse correlation between UPC and ECPC, a significant inverse correlation between SBP and ECPC and a weak but significant positive correlation between UPC and SBP. Some of the dogs with CRF were proteinuric and almost all were hypertensive. Neoplasia was commonly associated with proteinuria in the dogs with a normal ECPC. CRF was the most common cause leading to hypertension. In the dogs with CRF, hypertension and marked proteinuria were associated with significantly shorter survival times.

  6. Renal blood flow distribution during E. coli endotoxin shock in dog.

    Science.gov (United States)

    Kirkebø, A; Tyssebotn, I

    1980-04-01

    The effect of endotoxin on renal blood flow distribution was studied in anesthetized dogs. Renal blood flow was measured as hydrogen clearance by platinum electrodes placed in outer and in inner halves of cortex and by electromagnetic flowmeter. Intravenous injection of E. coli endotoxin, 3-5 mg/kg b. wt., promptly reduced arterial blood pressure (AP) and renal blood flow. After a transient increase for 45 min AP and renal blood flow declined to about 50% of the control 2 1/2-3 h after injection. The reduction in outer cortical blood flow (OCF) was not significantly different from the reduction in inner cortical blood flow (ICF). The hematocrit (Hct) increased from 40.1 +/- 3.8% to 54.6 +/- 8%, but mean renal vascular resistance did not change. Total plasma protein concentration was not significantly elevated. A marked local flow variability was observed in some periods during the phase of shock with declining AP and total renal blood flow at high Hct. Thus renal blood flow showed phasic changes, but the OCF/ICF ratio was not changed during endotoxin shock. Local blood flow instability was observed periodically at high Hct. PMID:6998257

  7. Renal function in atrial fibrillation patients switched from warfarin to a direct oral anticoagulant.

    Science.gov (United States)

    Minhas, Anum S; Jiang, Qingmei; Gu, Xiaokui; Haymart, Brian; Kline-Rogers, Eva; Almany, Steve; Kozlowski, Jay; Krol, Gregory D; Kaatz, Scott; Froehlich, James B; Barnes, Geoffrey D

    2016-11-01

    All available direct oral anticoagulants (DOACs) are at least partially eliminated by the kidneys. These agents are increasingly being used as alternatives to warfarin for stroke prevention in patients with atrial fibrillation. The aim of this study was to identify changes in renal function and associated DOAC dosing implications in a multicenter cohort of atrial fibrillation patients switched from warfarin to DOAC treatment. We included all patients in the Michigan Anticoagulation Quality Improvement Initiative cohort who switched from warfarin to a DOAC with atrial fibrillation as their anticoagulant indication between 2009 and 2014, and who had at least two creatinine values. Compliance with FDA-recommended dosing based on renal function was assessed. Of the 189 patients switched from warfarin to a DOAC, 34 (18.0 %) had a baseline creatinine clearance renal function. Of these 23 patients, 6 (26.1 %) should have impacted the DOAC dosing, but only 1 patient actually received an appropriate dose adjustment. Additionally, 15 (7.9 %) of patients on DOACs had a dose change performed, but only one patient demonstrated a change in renal function to justify the dose adjustment. Most atrial fibrillation patients who switched from warfarin to a DOAC had stable renal function. However, the majority of patients who had a change in renal function did not receive the indicated dose change. As the use of DOACs expands, monitoring of renal function and appropriate dose adjustments are critical.

  8. Malignant renal tumors in children

    Directory of Open Access Journals (Sweden)

    Justin Scott Lee

    2015-05-01

    Full Text Available Renal malignancies are common in children. While the majority of malignant renal masses are secondary to Wilms tumor, it can be challenging to distinguish from more aggressive renal masses. For suspicious renal lesions, it is crucial to ensure prompt diagnosis in order to select the appropriate surgical procedure and treatment. This review article will discuss the common differential diagnosis that can be encountered when evaluating a suspicious renal mass in the pediatric population. This includes clear cell sarcoma of the kidney, malignant rhabdoid tumor, renal medullary carcinoma and lymphoma. 

  9. Methotrexate Associated Renal Impairment Is Related to Delayed Elimination of High-Dose Methotrexate

    Directory of Open Access Journals (Sweden)

    Shi-Long Yang

    2015-01-01

    Full Text Available Although Methotrexate (MTX is an effective drug for the treatment of acute lymphoblastic leukemia (ALL, the toxicity remains a significant problem. In this prospective study, fifty-four patients with ALL were enrolled. 3 g or 5 g MTX/m2 was administered over 24 hours. Serum MTX concentrations were determined in 24, 48, and 96 hours after MTX infusion. Serum creatinine concentrations and creatinine clearance rate (CCR were determined before and 24 and 48 hours after MTX infusion. A total of 173 courses of MTX infusion were administered. The serum creatinine concentrations did not change much after MTX infusion while the CCR was gradually decreased. MTX clearance status was independently related to CCR decrease, with the risk of 8.07 to develop renal impairment in patients with delayed MTX elimination. Serum creatinine concentration, serum creatinine ratio, CCR, and CCR ratio at 24 hours were all related to MTX elimination delay. Patients with serum creatinine level >35.0 μmol/L, creatinine ratio >1.129, or CCR <100.0 mL/min were more likely to undergo MTX elimination delay. In conclusion, MTX could induce transient renal impairment and compromised renal function will delay MTX clearance. The serum creatinine concentration and the ratio and CCR are useful tools for evaluating MTX elimination status.

  10. Renal effects of the novel selective adenosine A1 receptor blocker SLV329 in experimental liver cirrhosis in rats.

    Directory of Open Access Journals (Sweden)

    Berthold Hocher

    Full Text Available Liver cirrhosis is often complicated by an impaired renal excretion of water and sodium. Diuretics tend to further deteriorate renal function. It is unknown whether chronic selective adenosine A(1 receptor blockade, via inhibition of the hepatorenal reflex and the tubuloglomerular feedback, might exert diuretic and natriuretic effects without a reduction of the glomerular filtration rate. In healthy animals intravenous treatment with the novel A(1 receptor antagonist SLV329 resulted in a strong dose-dependent diuretic (up to 3.4-fold and natriuretic (up to 13.5-fold effect without affecting creatinine clearance. Male Wistar rats with thioacetamide-induced liver cirrhosis received SLV329, vehicle or furosemide for 12 weeks. The creatinine clearance of cirrhotic animals decreased significantly (-36.5%, p<0.05, especially in those receiving furosemide (-41.9%, p<0.01. SLV329 was able to prevent this decline of creatinine clearance. Mortality was significantly lower in cirrhotic animals treated with SLV329 in comparison to animals treated with furosemide (17% vs. 54%, p<0.05. SLV329 did not relevantly influence the degree of liver fibrosis, kidney histology or expression of hepatic or renal adenosine receptors. In conclusion, chronic treatment with SLV329 prevented the decrease of creatinine clearance in a rat model of liver cirrhosis. Further studies will have to establish whether adenosine A(1 receptor antagonists are clinically beneficial at different stages of liver cirrhosis.

  11. NUMERICAL SIMULATION OF TIP-CLEARANCE FLOW IN CASCADE

    Institute of Scientific and Technical Information of China (English)

    2003-01-01

    The tip-clearance flow in a cascade was numerically simulated by solving the RANS equations of incompressible fluids. The computational model was based upon the artificial compressibility formulation proposed by Chorin. The Baldwin-Lomax turbulence model was used to make the governing equations closed. For the specific structure of tip-clearance flow, a multi-block grid structure was adopted to facilitate numerical computations. The comparison of numerical results with experimental data indicates that the present method is capable of simulating tip-clearance flows with satisfactory accuracy.

  12. Clearance from the anterior chamber of RBCs from human diabetics

    International Nuclear Information System (INIS)

    Erythrocytes from diabetic patients manifest decreased deformability and increased adherence. These abnormal membrane properties may diminish the ability of erythrocytes (RBCs) from diabetics to undergo deformation in passage through the trabecular meshwork. Using sodium chromate Cr 51-labeled RBCs from type I diabetic patients with proliferative retinopathy and normal control subjects, we studied RBC clearance from the rabbit anterior chamber. The mean time for 50% clearance (T50) of RBCs from diabetics (76 hours) was significantly longer than that for RBCs from normal subjects (19.5 hours). In this model, RBCs from diabetics have a slower clearance from the anterior chamber than do RBCs from normal subjects

  13. Computer simulations in comparison with in vivo measurements of nifedipine-induced changes in renal allograft hemodynamics.

    Science.gov (United States)

    Merkus, J W; van Asten, W N; Hilbrands, L B; Hoitsma, A J; Koene, R A; Skotnicki, S H

    1993-09-01

    Analysis of Doppler spectrum waveforms is increasingly used in the differential diagnosis of human renal allograft dysfunction. The physiologic interpretation of changes in Doppler spectra obtained from renal allografts, however, remains a major problem. Computer simulation models of the renal circulation may provide insight into the physiologic mechanisms responsible for changes in Doppler spectrum characteristics. The results of measurements of renal allograft hemodynamics with both determinations of PAH clearance and Doppler spectrum analysis in 11 kidney allograft recipients were explained physiologically using a computer simulation model of kidney allograft hemodynamics. Using PAH clearance and blood pressure measurements a significant decrease in RVR was found (from 0.32 +/- 0.17 to 0.20 +/- 0.07 mm Hg x min/ml, P nifedipine. The Doppler spectrum waveform obtained from interlobar renal arteries showed a decrease in the RI (from 0.60 +/- 0.04 to 0.56 +/- 0.06; P < 0.05) and Tmax (from 133 +/- 32 to 98 +/- 32 ms; P < 0.05). The user-designed simulation model of renal hemodynamics showed comparable changes of the waveform when, in the model, the analogs of blood pressure, impedance of the artery, and the impedance of the peripheral vascular bed were altered proportionally.

  14. Lenalidomide is effective and safe for the treatment of patients with relapsed multiple myeloma and very severe renal impairment.

    Science.gov (United States)

    João, Cristina; Freitas, José; Gomes, Fernando; Geraldes, Catarina; Coelho, Inês; Neves, Manuel; Lúcio, Paulo; Esteves, Susana; Esteves, Graça V

    2016-05-01

    Patients with multiple myeloma (MM) and severe renal impairment (SRI) have shorter survival than MM patients without renal failure. Although lenalidomide is a highly active drug, this immunomodulatory agent is frequently neglected in this context due to its predominant renal clearance and, consequently, an increased risk of toxicity. This risk might be overcome with the proper lenalidomide dose adjustment to renal function. This study evaluates the outcomes of 23 relapsed MM patients with SRI (baseline creatinine clearance (CrCl) aspirin. It is important to notice that, after initial dose adjustment of therapy, there should be a continuous process of dose adjustment, taking into account variations in renal function. Furthermore, lenalidomide dose adjustment should be made according to the individual tolerance, even with stable renal function. LenDex dose adjustment, according to these principles, does not negatively impact response and improves treatment tolerance. It has a clear potential to treat this group of patients and to induce long duration of responses [event-free survival (EFS) 20.5 m and overall survival (OS) 42.6 m]. PMID:27068406

  15. Estimation of glomerular filtration rate by sinistrin clearance using various approaches.

    Science.gov (United States)

    Buclin, T; Sechaud, R; Bertschi, A P; Decosterd, L A; Belaz, N; Appenzeller, M; Burnier, M; Biollaz, J

    1998-03-01

    Two protocols for the determination of glomerular filtration rate (GFR) from sinistrin clearance are considered: a bolus injection and a bolus followed by infusion. On both occasions, serial blood and urine samplings are scheduled up to 6 h. Four calculation methods are compared for estimating GFR from the data obtained during each protocol: classical UV/P (ratio of urinary excretion rate over plasma concentration) after bolus or bolus plus infusion; 2-point (log-linear slope multiplied by apparent volume of distribution); D/AUC (ratio of dose over area under the curve) after bolus; and Rin/P (ratio of infusion rate over steady-state concentration) during infusion. Some refinements of the calculations are devised. Data are simulated by running a bicompartmental pharmacokinetic model with renal elimination, and contaminating the values with an array of random errors. The statistical performance of the respective calculation methods is assessed by graphical means. The UV/P method performs poorly during 2 hours following the bolus; on both bolus and infusion data, it suffers from imprecision on the urinary volume. The 2-point method is acceptable between 1 and 4 h after bolus; later, the estimates become much less precise. The D/AUC method appears highly reliable when integrating the concentrations up to 3 h after bolus; it requires extrapolation towards infinity. The Rin/P method is satisfactory if applied later than 3 to 4 h after the loading dose. The advantages and drawbacks of each methods must be evaluated in relation with the particular clinical setting in which GFR is to be estimated. D/AUC represents the most advisable approach for snapshot renal testing in subjects or patients without important renal impairment. PMID:9574452

  16. Renal Actions of Neutral Endopeptidase Inhibition in Rats with Chronic Heart Failure

    Directory of Open Access Journals (Sweden)

    Amr M. Abbas

    2010-01-01

    Full Text Available Problem statement: We aim to evaluate the effects of acute and chronic inhibition of Neutral EndoPeptidase (NEP, by ONO-9902, on plasma and renal NEP gene expression, hemodynamic and renal parameters in rats with Chronic Heart Failure (CHF following left Coronary Artery Ligation (CAL. Approach: Forty eight male Sprague-Dawley rats (220-240 g were divided into sham and CAL groups. Myocardial infarction was induced by left CAL. All rats were further subdivided into untreated and orally treated with ONO-9902 (300 mg kg-1 day-1 from the 1st to 6th weeks after the operation. At the 1st and 6th weeks after the operation, gene expression of plasma and renal NEP, plasma ANP, cGMP and aldosterone concentrations, urine volume, Na and ANP excretion, creatinine clearance and renal cGMP generation were measured. Results: CAL leads to sodium and water retention, increased renal NEP gene expression, plasma ANP and aldosterone and decreased renal cGMP generation and plasma NEP gene expression. Acute treatment of CAL rats by ONO-9902, at the 1st week after the operation, inhibited plasma and renal NEP gene expression with increased plasma ANP, which caused diuresis, natriuresis and increased renal cGMP generation. Moreover, chronic treatment of those rats by ONO-9902 decreased plasma and renal NEP gene expression, plasma aldosterone, increased plasma ANP but non significantly, and caused diuresis, natriuresis with increased renal cGMP generation. GFR was not significantly changed before or after treatment. Conclusion: Chronic treatment with NEP inhibitor decreases Na and water retention in rats with CHF by enhancing ANP action and suppressing aldosterone secretion. So, ONO-9902 may offer a new therapeutic approach in patients with CHF.

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

    Directory of Open Access Journals (Sweden)

    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.

  18. Renal consequences of obesity.

    Science.gov (United States)

    Naumnik, Beata; Myśliwiec, Michał

    2010-08-01

    The worldwide prevalence of obesity and its associated metabolic and cardiovascular disorders has risen dramatically within the past 2 decades. Our objective is to review the mechanisms that link obesity with altered kidney function. Current evidence suggests that excess weight gain may be responsible for 65-75% of the risk for arterial hypertension. Impaired renal pressure natriuresis, initially due to increased renal tubular sodium reabsorption, is a key factor linking obesity with hypertension. Obesity increases renal sodium reabsorption by activating the renin-angiotensin and sympathetic nervous systems, and by altering intrarenal physical forces. Adipose tissue functions as an endocrine organ, secreting hormones/cytokines (e.g., leptin) which may trigger sodium retention and hypertension. Additionally, excess visceral adipose tissue may physically compress the kidneys, increasing intrarenal pressures and tubular reabsorption. Eventually, sustained obesity via hyperinsulinemia, due to resistance to insulin, causes hyperfiltration, resulting in structural changes in the kidneys--glomerular hyperthrophy and occasionally focal segmental glomerulosclerosis. The consequences of kidney injury are continuous loss of glomerular filtration rate, further increase of arterial pressure and escalation of cardiovascular morbidity and mortality. There is a growing awareness of the renal consequences of obesity, and considerable progress is being made in understanding its pathophysiology. Weight reduction results in lowered proteinuria. Aside from low sodium diet and exercises, more widespread use of renoprotective therapy (e.g., ACE inhibitors and statins) in treatment of hypertension in obese subjects should be advocated. Renal protection should result in reducing the cardiovascular complications of obesity. PMID:20671624

  19. Can renal infarction occur after renal cyst aspiration? Case report.

    Science.gov (United States)

    Emre, Habib; Soyoral, Yasemin Usul; Tanik, Serhat; Gecit, Ilhan; Begenik, Huseyin; Pirincci, Necip; Erkoc, Reha

    2011-01-01

    Renal infarction (RI) is a rarely seen disorder, and the diagnosis is often missed. The two major causes of RI are thromboemboli originhating from a thrombus in the heart or aorta, and in-situ thrombosis of a renal artery. We report a case of RI that developed due to renal artery and vein thrombosis, as confirmed by pathological evaluation of the nephrectomy material, three weeks after renal cyst aspiration.

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

    Science.gov (United States)

    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

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

    Energy Technology Data Exchange (ETDEWEB)

    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.)

  2. Renal sympathetic denervation: MDCT evaluation of the renal arteries.

    LENUS (Irish Health Repository)

    Hutchinson, Barry D

    2013-08-01

    Percutaneous transluminal renal sympathetic denervation is a new treatment of refractory systemic hypertension. The purpose of this study was to assess the clinical utility of MDCT to evaluate the anatomic configuration of the renal arteries in the context of renal sympathetic denervation.

  3. Renal (Kidney) Manifestations in TSC

    Science.gov (United States)

    ... International TSC Research Conference Text Size Get Involved RENAL (KIDNEY) MANIFESTATIONS IN TSC Download a PDF of ... sclerosis complex (TSC) will develop some form of renal (kidney) disease during their lifetime. There are three ...

  4. Renal (Kidney) Manifestations in TSC

    Medline Plus

    Full Text Available ... For Individuals & Families For Healthcare Professionals For Researchers & Scientists For School Issues What Is TSC? How Is ... must be kept in mind. Diagnosis The current methods to diagnosis these renal abnormalities include renal ultrasonography, ...

  5. Renal (Kidney) Manifestations in TSC

    Medline Plus

    Full Text Available ... lesion must be kept in mind. Diagnosis The current methods to diagnosis these renal abnormalities include renal ... about clinical trials and see a list of current trials/studies related to TSC. Enroll now in ...

  6. Renal (Kidney) Manifestations in TSC

    Medline Plus

    Full Text Available ... Get Involved RENAL (KIDNEY) MANIFESTATIONS IN TSC Download a PDF of this information. The majority of individuals ( ... the least common renal association with TSC, is a cancerous growth of the kidney. Although it is ...

  7. Polyhydramnios and acute renal failure

    OpenAIRE

    Hamilton, D. V.; Kelly, Moira B.; Pryor, J. S.

    1980-01-01

    Acute renal failure secondary to ureteric obstruction is described in a primigravida with twin gestation and polyhydramnios. Relief of the obstruction occurred on drainage of the liquor and return to normal renal function following delivery.

  8. Renal Tumor Biopsy Technique

    Institute of Scientific and Technical Information of China (English)

    Lei Zhang; Xue-Song Li; Li-Qun Zhou

    2016-01-01

    Objective:To review hot issues and future direction of renal tumor biopsy (RTB) technique.Data Sources:The literature concerning or including RTB technique in English was collected from PubMed published from 1990 to 2015.Study Selection:We included all the relevant articles on RTB technique in English,with no limitation of study design.Results:Computed tomography and ultrasound were usually used for guiding RTB with respective advantages.Core biopsy is more preferred over fine needle aspiration because of superior accuracy.A minimum of two good-quality cores for a single renal tumor is generally accepted.The use of coaxial guide is recommended.For biopsy location,sampling different regions including central and peripheral biopsies are recommended.Conclusion:In spite of some limitations,RTB technique is relatively mature to help optimize the treatment of renal tumors.

  9. Embolic renal infarction mimicking renal colic

    OpenAIRE

    Mahamid M; Francis A.; Abid A; Awawde M; Abu-Elhija O

    2014-01-01

    Mahmud Mahamid,1,3 Adi Francis,2 Ali Abid,1 Mohammed Awawde,1 Omar Abu-Elhija11Department of Internal Medicine, 2Cardiac Care Unit, Holy Family Hospital, Bar-Ilan University, Nazareth, Israel; 3Digestive Disease Institute, Liver Unit, Shaare Zedek Medical Center, Jerusalem, IsraelAbstract: Atrial fibrillation is a major health problem with risk of systemic arterial embolism. Acute embolic renal infarction is a rare condition with symptoms that are often nonspecific. We present a 36-year-old p...

  10. The compliance contact model of cylindrical joints with clearances

    Institute of Scientific and Technical Information of China (English)

    Caishan Liu; Ke Zhang; Lei Yang; Keren Wang

    2005-01-01

    This paper is concerned with the determination of the normal force-displacement (NFD) relation for the contact problem of cylindrical joints with clearance. A simple formulation for this contact problem is developed by modeling the pin as a rigid wedge and the elastic plate as a simple Winkler elastic foundation. The numerical results show that the normal displacement relation based on Hertz theory is only valid for the case of large clearance with a small normal load, and the NFD relation based on Persson theory is only effective in the case of very small clearance. The proposed approximate model in this paper gives better results than Hertz theory and Persson theory in a large range of clearances as seen from the comparison with the results of FEM.

  11. Design Optimization of Ground Clearance of Domestic Cars

    Directory of Open Access Journals (Sweden)

    Debojyoti Mitra

    2010-07-01

    Full Text Available Drag and lift forces plays a vital role in the performance and stability of vehicles. Less drag means less fuel consumption and hence less vehicular pollution. Also, lower lift force means higher chance of adhesion of the car body with the ground causing less overturning of the vehicle, which improves the vehicle performance. Both drag and lift forces can be manipulated by varying the ground clearance of the cars. The present study concentrates on studying the effect of ground clearance on these aerodynamic forces experimentally. Wind tunnel studies with a notch-back car model revealed increase in drag and decrease in lift with increase in ground clearance. Therefore, optimization is required for designing the best ground clearance and a preferable value of the same is thus obtained.

  12. 49 CFR 229.71 - Clearance above top of rail.

    Science.gov (United States)

    2010-10-01

    ..., DEPARTMENT OF TRANSPORTATION RAILROAD LOCOMOTIVE SAFETY STANDARDS Safety Requirements Suspension System § 229.71 Clearance above top of rail. No part or appliance of a locomotive except the wheels,...

  13. IFNL4 affects clearance of hepatitis C virus

    Science.gov (United States)

    Scientists have discovered a new human interferon gene, Interferon Lambda 4 (IFNL4), that affects clearance of the hepatitis C virus. They also identified an inherited genetic variant within IFNL4 that predicts how people respond to treatment for hepatit

  14. Renal denervation and hypertension.

    Science.gov (United States)

    Schlaich, Markus P; Krum, Henry; Sobotka, Paul A; Esler, Murray D

    2011-06-01

    Essential hypertension remains one of the biggest challenges in medicine with an enormous impact on both individual and society levels. With the exception of relatively rare monogenetic forms of hypertension, there is now general agreement that the condition is multifactorial in nature and hence requires therapeutic approaches targeting several aspects of the underlying pathophysiology. Accordingly, all major guidelines promote a combination of lifestyle interventions and combination pharmacotherapy to reach target blood pressure (BP) levels in order to reduce overall cardiovascular risk in affected patients. Although this approach works for many, it fails in a considerable number of patients for various reasons including drug-intolerance, noncompliance, physician inertia, and others, leaving them at unacceptably high cardiovascular risk. The quest for additional therapeutic approaches to safely and effectively manage hypertension continues and expands to the reappraisal of older concepts such as renal denervation. Based on the robust preclinical and clinical data surrounding the role of renal sympathetic nerves in various aspects of BP control very recent efforts have led to the development of a novel catheter-based approach using radiofrequency (RF) energy to selectively target and disrupt the renal nerves. The available evidence from the limited number of uncontrolled hypertensive patients in whom renal denervation has been performed are auspicious and indicate that the procedure has a favorable safety profile and is associated with a substantial and presumably sustained BP reduction. Although promising, a myriad of questions are far from being conclusively answered and require our concerted research efforts to explore the full potential and possible risks of this approach. Here we briefly review the science surrounding renal denervation, summarize the current data on safety and efficacy of renal nerve ablation, and discuss some of the open questions that need

  15. Contemporary Management of Renal Trauma

    Science.gov (United States)

    Shoobridge, Jennifer J; Corcoran, Niall M; Martin, Katherine A; Koukounaras, Jim; Royce, Peter L; Bultitude, Matthew F

    2011-01-01

    In the management of renal trauma, surgical exploration inevitably leads to nephrectomy in all but a few specialized centers. With current management options, the majority of hemodynamically stable patients with renal injuries can be successfully managed nonoperatively. Improved radiographic techniques and the development of a validated renal injury scoring system have led to improved staging of injury severity that is relatively easy to monitor. This article reviews a multidisciplinary approach to facilitate the care of patients with renal injury. PMID:21941463

  16. The optimal clearance design of micro-punching die

    Directory of Open Access Journals (Sweden)

    K.S. Lee

    2008-07-01

    Full Text Available Purpose: The purpose of this research paper is focused on the optimal clearance design of micro-punching die by abductive network and SA method.Design/methodology/approach: The punching data (input and wear size (output were collected for a training database. In order to select proper clearance to evaluate the wear of die, the abductive network was used to establish an efficient relationship between input parameters and output result. This can help to predict wear size under any degree of clearance and hence to replace worn punches and dies at the right time. A simulated annealing (SA optimization algorithm with a performance index is then applied to the neural network for searching the optimal clearance parameters, and obtains rather satisfactory result as compared with the corresponding experiment verification.Findings: This study aims to identify the relationship between clearance and service life of micro punches using the Neural Network, and to find relational data involving the service life of punches and punching parameters in non-metal blanking processes. The result can be used to estimate optimal clearance between punch and die for industrial applications.Research limitations/implications: In this study, the practical punching processes with different punching conditions were carried out for a set of training data. A trained model exhibited a relationship between service life and clearance of micro punch and die through an abductive network system. The predicted value of wear by abductive network is very close to the actual experimental value, with an error of less than 8%. This result satisfies the required standard for IC factory production.Originality/value: A good clearance design not only increases the quality of product manufactured, but also reduces product’s burr. As a result, the wear of punches and dies can be greatly reduced and the life expectancy of punching dies increased.

  17. Fluid damping clearance in a control valve of injector

    Institute of Scientific and Technical Information of China (English)

    ZHANG Jianming; ZHANG Weigang; YANG Bing; WANG Yawei

    2007-01-01

    A force model of a control valve of injector is set up, and the changes of the fluid damping clearance are investigated on the basis of the results of the computational fluid dynamics (CFD) and the experiments of control valve of injector. Results indicate that a damping clearance of 0.02-0.03 mm between the poppet and the valve guide is the most sufficient to dampen any excessive control valve poppet bouncing.

  18. Renal Failure in Pregnancy.

    Science.gov (United States)

    Balofsky, Ari; Fedarau, Maksim

    2016-01-01

    Renal failure during pregnancy affects both mother and fetus, and may be related to preexisting disease or develop secondary to diseases of pregnancy. Causes include hypovolemia, sepsis, shock, preeclampsia, thrombotic microangiopathies, and renal obstruction. Treatment focuses on supportive measures, while pharmacologic treatment is viewed as second-line therapy, and is more useful in mitigating harmful effects than treating the underlying cause. When supportive measures and pharmacotherapy prove inadequate, dialysis may be required, with the goal being to prolong pregnancy until delivery is feasible. Outcomes and recommendations depend primarily on the underlying cause.

  19. Renal lithiasis and nutrition

    Directory of Open Access Journals (Sweden)

    Prieto Rafel M

    2006-09-01

    Full Text Available Abstract Renal lithiasis is a multifactorial disease. An important number of etiologic factors can be adequately modified trough diet, since it must be considered that the urine composition is directly related to diet. In fact, the change of inappropriate habitual diet patterns should be the main measure to prevent kidney stones. In this paper, the relation between different dietary factors (liquid intake, pH, calcium, phosphate, oxalate, citrate, phytate, urate and vitamins and each type of renal stone (calcium oxalate monohydrate papillary, calcium oxalate monohydrate unattached, calcium oxalate dihydrate, calcium oxalate dihydrate/hydroxyapatite, hydroxyapatite, struvite infectious, brushite, uric acid, calcium oxalate/uric acid and cystine is discussed.

  20. Renal Failure in Pregnancy.

    Science.gov (United States)

    Balofsky, Ari; Fedarau, Maksim

    2016-01-01

    Renal failure during pregnancy affects both mother and fetus, and may be related to preexisting disease or develop secondary to diseases of pregnancy. Causes include hypovolemia, sepsis, shock, preeclampsia, thrombotic microangiopathies, and renal obstruction. Treatment focuses on supportive measures, while pharmacologic treatment is viewed as second-line therapy, and is more useful in mitigating harmful effects than treating the underlying cause. When supportive measures and pharmacotherapy prove inadequate, dialysis may be required, with the goal being to prolong pregnancy until delivery is feasible. Outcomes and recommendations depend primarily on the underlying cause. PMID:26600445

  1. Experimental study on fluid flow in arciform clearance

    Institute of Scientific and Technical Information of China (English)

    邵俊鹏; 汤卉; 贾慧娟

    2002-01-01

    The system damping and dynamic characteristics can be further improved by properly increasing thedamping coefficient ξh. For a special hydraulic damping structure, an arciform damping clearance often used inFCS, a mathematical model has been established for fluid flow using the theory of laminar flow in the clearanceof parallel plates. Analytical calculations are made for fluid flow in the arciform clearance and relational expres-sion is deduced for flow rate along the arciform cleaance height, pressure difference, maximum arciform clear-ance height, the flow rate for the fluid flow in arciform clearance as well, and its simplified formula is obtainedby using the theory of hydrodynamics and the curve - fitting method. This paper consists of two sections: the firstsection focuses on the theoretical analysis by using the simplified mathematical model and the second sectionmainly describes experimental analysis. The simplified formula is corrected with experimental results by consid-erig various boundary conditions of the damping clearance. Experimental results show that this study of arciformdamping clearance is reliable and practical.

  2. Model of mucociliary clearance in cystic fibrosis lungs.

    Science.gov (United States)

    Kurbatova, P; Bessonov, N; Volpert, V; Tiddens, H A W M; Cornu, C; Nony, P; Caudri, D

    2015-05-01

    Mucus clearance is a primary innate defense mechanism in the human airways. Cystic fibrosis (CF) is a genetic disease caused by mutations in the gene encoding the cystic fibrosis transmembrane conductance regulator (CFTR) protein. CF is characterized by dehydration of airway surface liquid and impaired mucociliary clearance. As a result, microorganisms are not efficiently removed from the airways, and patients experience chronic pulmonary infections and inflammation. We propose a new physiologically based mathematical model of muco-ciliary transport consisting of the two major components of the mucociliary clearance system: (i) periciliary liquid layer (PCL) and (ii) mucus layer. We study mucus clearance under normal conditions and in CF patients. Restoring impaired clearance of airway secretions in one of the major goals of therapy in patients with CF. We consider the action of the aerosolized and inhaled medication dornase alfa, which reduces the viscosity of cystic fibrosis mucus, by selectively cleaving the long DNA strands it contains. The results of the model simulations stress the potential relevance of the location of the drug deposition in the central or peripheral airways. Mucus clearance was increased in case the drug was primarily deposited peripherally, i.e. in the small airways. PMID:25746843

  3. Effect of renal impairment on the pharmacokinetics of prucalopride: a single- dose open-label Phase I study

    Directory of Open Access Journals (Sweden)

    Smith WB

    2012-12-01

    Full Text Available William B Smith,1 Erik Mannaert,2 Tom Verhaeghe,2 René Kerstens,3 Lieve Vandeplassche,3 Vera Van de Velde41Volunteer Research Group and New Orleans Center for Clinical Research, The University of Tennessee Medical Center, Knoxville, TN, USA; 2Janssen Research and Development, a division of Janssen Pharmaceutica NV, Beerse, Belgium; 3Shire-Movetis NV, Turnhout, Belgium; 4Independent Consultant Clinical Pharmacokinetics, Princeton, NJ, USAObjective: To evaluate the pharmacokinetics of prucalopride in individuals with renal impairment (RI.Methods: This open-label Phase I study (ClinicalTrials.gov identifier: NCT01674192 enrolled men and women aged 18–75 years who were classified by renal function: normal renal function (creatinine clearance ≥ 80 mL/min/1.73 m2, mild RI (50–79 mL/min/1.73 m2, moderate RI (25–49 mL/min/1.73 m2, and severe RI (≤24 mL/min/1.73 m2. All received a single oral dose of prucalopride 2 mg.Results: Thirty-four individuals (normal renal function: 10; mild RI: 8; moderate RI: 7; severe RI: 9 received prucalopride. In all groups, maximum plasma concentration was reached within 2–4 hours. There was no significant difference in exposure (area under the plasma concentration–time curve from time zero to infinity between participants with mild RI and those with normal renal function. However, area under the plasma concentration–time curve from time zero to infinity values were 1.5- and 2.3-fold higher (P = 0.002 and P < 0.001 in patients with moderate RI and severe RI, respectively, than in those with normal renal function. The proportion of total body clearance accounted for by renal clearance was significantly reduced in those with RI.Conclusion: Clinically meaningful reductions in renal clearance were seen in participants with severe RI, which supports a decrease from the standard dose of prucalopride 2 mg daily to 1 mg daily in these individuals.Keywords: renal impairment, pharmacokinetics, prucalopride, safety

  4. Renal protection during the operation of infrarenal aorta

    Directory of Open Access Journals (Sweden)

    Stanić Mirjana B.

    2002-01-01

    during ACC, 2 and 8 hours after ACC, on day 1, 2 and 3 postoperatively haemodynamic parameters (mean arterial and central venous pressure, volume load, urinary output, creatinine and free-water clearance, serum electrolytes, BUN, creatinine, plasma and urine osmolality and ACC time were analyzed in each patient. Renal complications were classified as transient or persistent. Transient renal dysfunction was defined as a greater rise Belgrade than 20% rise in peak serum creatinine level over baseline serum creatinine level, with a peak of at least 168 pmol/L. Persistent renal insufficiency was defined as a greater rise than 20% rise in discharge serum creatinine level over baseline serum creatinine level, with a peak of at least 168 umol/L. Moreover, renal insufficiency was defined as a free-water clearance greater than -15 ml/h. Aortic cross-clamping time was defined as a period in which the proximal inflow was occluded. The results were expressed as means ± SD. Statistical difference detected with Student's t-test, with p < 0.05 being considered significant. RESULTS Patients in groups A and V were similar regarding the age (64.32 vs. 62.00, sex (males 35, females vs. males 34, females 6 and preoperative diseases. (Tab. 2 No difference was found between groups regarding any of the parameters (BUN, serum creatinine electrolytes, volum load, creatinine and free-water clearance, haemodynamic parameters, plasma and urine osmolality. Urinary output was higher in group V during and 2 hours after ACC. (Graph 1 ACC time was similar in two groups (24.1 min vs 24.5 min. (Graph. 2 Only one patient in group V revealed transitory renal insufficiency, not requiring special treatment. These data indicate that renal protection did not influence renal function. Short ACC time may have impact on the obtained results. Our results suggest that renal protection should not be considered as mandatory for elective infrarenal aortic surgery. Because of the short ACC time observed in this study

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

    Directory of Open Access Journals (Sweden)

    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.

  6. Determination of optimal blood pressure for patients with IgA nephropathy based on renal histology.

    Science.gov (United States)

    Osawa, Y; Narita, I; Imai, N; Iino, N; Iguchi, S; Ueno, M; Shimada, H; Nishi, S; Arakawa, M; Gejyo, F

    2001-03-01

    To evaluate the optimal BP control for patients with IgA nephropathy (IgAN) based on the histologic severity of the nephropathy and the degree of renal dysfunction. We analyzed 332 consecutive renal biopsy specimens and clinical data from patients with IgAN. Patients were divided into three groups based on their BP at the time of biopsy: an optimal BP (SBP or = 140 mmHg and/or DBP > or = 90 mmHg), and an intermediate BP group. Each biopsy specimen was evaluated for mesangial proliferation, degree of sclerosis and/or hyalinosis of the arterioles and the interlobular artery using a semiquantitative method. Creatinine clearance and the percentage of sclerosed glomeruli were also determined. Both the degree of renal dysfunction and the histologic changes correlated significantly with BP, even in patients with a BP <140/90 mmHg. The patients with an optimal BP at the time of biopsy had significantly less histologic damage with respect to mesangial proliferation and vessel changes than those with an intermediate or hypertensive BP. In the patients with a hypertensive BP, the percentage of sclerotic glomeruli was significantly higher and the creatinine clearance was significantly lower. The optimal BP proposed by the WHO in 1999 prevents histologic evidence of renal damage for patients with IgAN.

  7. Correlation between cystatin C-based formulas, Schwartz formula and urinary creatinine clearance for glomerular filtration rate estimation in children with kidney disease

    Science.gov (United States)

    Safaei-Asl, Afshin; Enshaei, Mercede; Heydarzadeh, Abtin; Maleknejad, Shohreh

    2016-01-01

    Introduction: Assessment of glomerular filtration rate (GFR) is an important tool for monitoring renal function. Objectives: Regarding to limitations in available methods, we intended to calculate GFR by cystatin C (Cys C) based formulas and determine correlation rate of them with current methods. Patients and Methods: We studied 72 children (38 boys and 34 girls) with renal disorders. The 24 hour urinary creatinine (Cr) clearance was the gold standard method. GFR was measured with Schwartz formula and Cys C-based formulas (Grubb, Hoek, Larsson and Simple). Then correlation rates of these formulas were determined. Results: Using Pearson correlation coefficient, a significant positive correlation between all formulas and the standard method was seen (R2 for Schwartz, Hoek, Larsson, Grubb and Simple formula was 0.639, 0.722, 0.705, 0.712, 0.722, respectively) (Pcorrelation with Schwarz formula by R2 0.62-0.65 (intermediate correlation). Using linear regression and constant (y-intercept), it revealed that Larsson, Hoek and Grubb formulas can estimate GFR amounts with no statistical difference compared with standard method; but Schwartz and Simple formulas overestimate GFR. Conclusion: This study shows that Cys C–based formulas have strong relationship with 24 hour urinary Cr clearance. Hence, they can determine GFR in children with kidney injury, easier and with enough accuracy. It helps the physician to diagnosis of renal disease in early stages and improves the prognosis.

  8. The effect of improved modelling of plasma clearance in paediatric patients with expanded body spaces on estimation of the glomerular filtration rate

    International Nuclear Information System (INIS)

    The glomerular filtration rate (GFR) is used clinically to assess renal function. The most accurate estimation technique is tracer clearance where deterministic compartment pharmacokinetic models are most widely used. The aim of this study was to assess the viability of alternative pharmacokinetic models to describe tracer clearance, and in turn, measure GFR. This study was carried out on 126 clearance datasets obtained from 44 patients with large solid tumours; these were fitted to four pharmacokinetic models with superiority of model determined by Akaike Information Criteria. A fractal model was found to be superior to the best deterministic compartment model (70% of datasets, P < 0.0020) as was a gamma-distributed residence time model (93% of datasets, P < 0.0020); both models also gave greater mean weighted coefficients of determination than deterministic compartment models. These results suggest that gamma-distributed residence time and fractal models better describe tracer clearance than deterministic compartment models and therefore should allow more accurate estimation of GFR

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

    Directory of Open Access Journals (Sweden)

    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.

  10. Insuficiencia renal aguda.

    Directory of Open Access Journals (Sweden)

    Carlos Hernán Mejía

    2009-10-01

    Full Text Available La insuficiencia renal aguda se diagnostica aproximadamente en 5% de los pacientes hospitalizados. Sus principales causas se relacionan con la alteración del flujo sanguíneo renal, sea por depleción de volumen, baja perfusión renal o por distribución intrarrenal inadecuada y obstrucción del árbol urinario. El diagnóstico parte de la historia clínica y un buen examen físico que corrobore el estado de volemia del paciente y se complementa con el uso adecuado de los índices urinarios (excreción de sodio y osmolaridad, el uroanálisis y la ecografía renal. Su tratamiento consiste en una adecuada recuperación del volumen, manejo de los diuréticos, soporte nutricional, conservación del equilibrio hidroelectrolítico y brindar terapia de diálisis si hay toxicidad urémica, hipercaliemia severa (>6.5 mEq/l, acidosis metabólica o sobrecarga severa de volumen.

  11. Management of Renal Cysts

    Science.gov (United States)

    Nalbant, Ismail; Can Sener, Nevzat; Firat, Hacer; Yeşil, Süleyman; Zengin, Kürşad; Yalcınkaya, Fatih; Imamoglu, Abdurrahim

    2015-01-01

    Background and Objectives: Renal cysts have a high prevalence in the general population, and their estimated incidence increases with age. Renal cyst aspiration (usually with sclerotherapy) or open/laparoscopic decortication is a generally effective and safe method in the treatment of symptomatic simple renal cysts. The success rates of laparoscopic decortication and percutaneous aspiration-sclerotherapy were compared to assist in the decision making for the procedure. Methods: A total of 184 patients with symptomatic simple renal cysts were treated with either laparoscopic decortication in 149 cases or percutaneous aspiration-sclerotherapy in 35 cases. The follow-up period was approximately 35 months, and the symptomatic and radiologic success rates of the 2 techniques were compared retrospectively. Results: Laparoscopic decortication was found to have high success rates, a low recurrence rate, and minimal morbidity. Percutaneous aspiration-sclerotherapy is an outpatient procedure with a minimally higher recurrence rate. Conclusion: When a symptomatic cyst is encountered and treatment of the cyst is indicated, laparoscopic decortication is a more efficient method that offers better results than percutaneous aspiration-sclerotherapy. PMID:25848184

  12. Rupture of Renal Transplant

    Directory of Open Access Journals (Sweden)

    Shona Baker

    2015-01-01

    Full Text Available Background. Rupture of renal allograft is a rare and serious complication of transplantation that is usually attributed to acute rejection, acute tubular necrosis, or renal vein thrombosis. Case Presentation. LD, a 26-year-old male with established renal failure, underwent deceased donor transplantation using kidney from a 50-year-old donor with acute kidney injury (Cr 430 mmol/L. LD had a stormy posttransplant recovery and required exploration immediately for significant bleeding. On day three after transplant, he developed pain/graft swelling and another significant haemorrhage with cardiovascular compromise which did not respond to aggressive resuscitation. At reexploration, the renal allograft was found to have a longitudinal rupture and was removed. Histology showed features of type IIa Banff 97 acute vascular rejection, moderate arteriosclerosis, and acute tubular necrosis. Conclusion. Possible ways of avoiding allograft rupture include use of well-matched, good quality kidneys; reducing or managing risk factors that would predispose to delayed graft function; ensuring a technically satisfactory transplant procedure with short cold and warm ischemia times; and avoiding large donor-recipient age gradients.

  13. Primary renal graft thrombosis

    NARCIS (Netherlands)

    Bakir, N; Sluiter, WJ; Ploeg, RJ; van Son, WJ; Tegzess, Adam

    1996-01-01

    Background. Renal allograft thrombosis is a serious complication of kidney transplantation that ultimately leads to graft loss. Its association with acute and hyperacute rejection is well documented; however, in a large proportion of patients the precise cause remains obscure. The exact incidence an

  14. In situ lactate dehydrogenase activity - a novel renal cortical imaging biomarker of tubular injury?

    DEFF Research Database (Denmark)

    Nielsen, Per Mose; Laustsen, Christoffer; Bertelsen, Lotte Bonde;

    2016-01-01

    Renal ischemia/reperfusion injury is the state of which a tissue experience injury after a phase of restrictive blood supply and recirculation. Ischemia/reperfusion injury (I/R-I) is a leading cause of acute kidney injury (AKI) in several disease states, including kidney transplantation, sepsis...... and hypovolemic shock. The most common methods to evaluate AKI are creatinine clearance, plasma creatinine, blood urea nitrogen (BUN) or renal histology. However, there is currently a lack of precise methods to directly assess renal injury state non-invasively. Hyperpolarized 13C-pyruvate magnetic resonance...... with 30 min and 60 min of ischemia followed by 24 hours of reperfusion. The pyruvate conversion was unaltered compared to sham in the 30 min I/R-I group while a significant reduced metabolic conversion was found in the post-ischemic kidney after 60 min of ischemia. This indicates that after 30 min...

  15. A histopathological score on baseline biopsies from elderly donors predicts outcome 1 year after renal transplantation

    DEFF Research Database (Denmark)

    Toft, Birgitte G; Federspiel, Birgitte H; Sørensen, Søren S;

    2012-01-01

    Kidneys from elderly deceased patients and otherwise marginal donors may be considered for transplantation and a pretransplantation histopathological score for prediction of postoperative outcome is warranted. In a retrospective design, 29 baseline renal needle biopsies from elderly deceased donors...... wall thickness of arteries and/or arterioles. Nineteen renal baseline biopsies from 15 donors (age: 64 ± 10 years) were included and following consensus the histopathological score was 4.3 ± 2.1 (intraclass correlation coefficient: 0.81; confidence interval: 0.66-0.92). The donor organs were used...... for single renal transplantation (recipient age: 47 ± 3 years). Two grafts were lost after the transplantation. In the remaining 17 recipients the 1-year creatinine clearance (54 ± 6 mL/min) correlated to the baseline histopathological score (r(2) = 0.59; p

  16. Neuroendocrine and renal effects of intravascular volume expansion in compensated heart failure

    DEFF Research Database (Denmark)

    Gabrielsen, A; Bie, P; Holstein-Rathlou, N H;

    2001-01-01

    To examine if the neuroendocrine link between volume sensing and renal function is preserved in compensated chronic heart failure [HF, ejection fraction 0.29 +/- 0.03 (mean +/- SE)] we tested the hypothesis that intravascular and central blood volume expansion by 3 h of water immersion (WI) elicits...... sustained angiotensin-converting enzyme inhibitor therapy, n = 9) absolute and fractional sodium excretion increased (P Renal free water clearance increased during WI in control subjects but not in HF......, albeit plasma vasopressin concentrations were similar in the two groups. In conclusion, the neuroendocrine link between volume sensing and renal sodium excretion is preserved in compensated HF. The natriuresis of WI is, however, modulated by the prevailing ANG II and Aldo concentrations. In contrast...

  17. Comparative Pharmacokinetics of Levofloxacin in Healthy and Renal Damaged Muscovy Ducks following Intravenous and Oral Administration

    Directory of Open Access Journals (Sweden)

    Mohamed Aboubakr

    2014-01-01

    Full Text Available The pharmacokinetics aspects of levofloxacin were studied in healthy and experimentally renal damaged Muscovy ducks after single intravenous (IV and oral (PO dose of 10 mg kg−1 bwt. Following IV administration, elimination half-life (t1/2(β and mean residence time (MRT were longer in renal damaged ducks than in healthy ones. Total clearance (Cltot in renal damaged ducks (0.20 L kg−1 h−1 was significantly lower as compared to that in healthy ones (0.41 L kg−1 h−1. Following PO administration, the peak serum concentration (Cmax was higher in renal damaged than in healthy ducks and was achieved at maximum time (tmax of 2.47 and 2.05 h, respectively. The drug was eliminated (t1/2(el at a significant slower rate (3.94 h in renal damaged than in healthy ducks (2.89 h. The pharmacokinetic profile of levofloxacin is altered in renal damaged ducks due to the increased serum levofloxacin concentrations compared with that in clinically healthy ducks. Oral administration of levofloxacin at 10 mg kg−1 bwt may be highly efficacious against susceptible bacteria in ducks. Also, the dose of levofloxacin should be reduced in renal damaged ducks. Pharmacokinetic/pharmacodynamic integration revealed significantly higher values for Cmax/MIC and AUC/MIC ratios in renal damaged ducks than in healthy ones, indicating the excellent pharmacokinetic characteristics of levofloxacin in renal damaged ducks.

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

    DEFF Research Database (Denmark)

    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...

  19. ``Aggressive`` renal angiomyolipoma

    Energy Technology Data Exchange (ETDEWEB)

    Cittadini, G. Jr. [Univ. of Genoa (Italy). Dept. of Radiology; Pozzi Mucelli, F. [Univ. of Trieste (Italy). Dept. of Radiology; Danza, F.M. [Catholic Sacro Cuore Univ., Rome (Italy). Dept. of Radiology; Derchi, L.E. [Univ. of Genoa (Italy). Dept. of Radiology; Pozzi Mucelli, R.S. [Univ. of Trieste (Italy). Dept. of Radiology

    1996-11-01

    We describe the US and CT examinations of 4 patients with renal angiomyolipoma with an `aggressive` appearance, and review the literature. The imaging findings in 4 patients with benign renal angiomyolipomas associated with thrombosis of the renal vein and/or inferior vena cava are presented. CT demonstrated fat densities within both tumor and thrombus. In one patient, small lymph nodes with low density internal areas were detected in the para-aortic region. When considering our patients together with those reported in the literature, we found that most angiomyolipomas with venous invasion were large and centrally located within the kidney. Venous thrombosis was observed in 9 lesions of the right kidney, and in only 4 of the left one. One patient only had symptoms due to the thrombus; 10 had problems due to the tumor; and 3 were asymptomatic. Only 4 patients with pararenal enlarged lymph nodes have been reported on in the imaging literature. Fat-containing nodes were detected by CT in one case only; the others had enlarged nodes of soft-tissue density. In one patient the diagnosis of hamartomatous lymph node invasion was established by angiography. In patients with renal angiomyolipoma, demonstration of both fatty thrombus and the fatty infiltration of lymph nodes of the renal hilum cannot be regarded as an indication of malignancy, but only of local aggessive behavior. Conservative treatment seems possible. Detection of enlarged lymph nodes of soft tissue density may cause difficult diagnostic problems, with the diagnosis addressed only by the presence of associated lesions. (orig./MG).

  20. [Renal abnormalities in ankylosing spondylitis].

    Science.gov (United States)

    Samia, Barbouch; Hazgui, Faiçal; Abdelghani, Khaoula Ben; Hamida, Fethi Ben; Goucha, Rym; Hedri, Hafedh; Taarit, Chokri Ben; Maiz, Hedi Ben; Kheder, Adel

    2012-07-01

    We will study the epidemiologic, clinical, biological, therapeutic, prognostic characteristics and predictive factors of development of nephropathy in ankylosing spondylitis patients. We retrospectively reviewed the medical record of 32 cases with renal involvement among 212 cases of ankylosing spondylitis followed in our service during the period spread out between 1978 and 2006. The renal involvement occurred in all patients a mean of 12 years after the clinical onset of the rheumatic disease. Thirty-two patients presented one or more signs of renal involvement: microscopic hematuria in 22 patients, proteinuria in 23 patients, nephrotic syndrome in 11 patients and decreased renal function in 24 patients (75%). Secondary renal amyloidosis (13 patients), which corresponds to a prevalence of 6,1% and tubulointerstitial nephropathy (7 patients) were the most common cause of renal involvement in ankylosing spondylitis followed by IgA nephropathy (4 patients). Seventeen patients evolved to the end stage renal disease after an average time of 29.8 ± 46 months. The average follow-up of the patients was 4,4 years. By comparing the 32 patients presenting a SPA and renal disease to 88 with SPA and without nephropathy, we detected the predictive factors of occurred of nephropathy: tobacco, intense inflammatory syndrome, sacroileite stage 3 or 4 and presence of column bamboo. The finding of 75% of the patients presented a renal failure at the time of the diagnosis of renal involvement suggests that evidence of renal abnormality involvement should be actively sought in this disease. PMID:22520483

  1. Some effects of ammonium salts on renal histology and function in the dog.

    Science.gov (United States)

    Orvell, B D; Wesson, L G

    1976-01-01

    NH4Cl was infused into the left renal artery of anesthetized dogs at 50-125 mum/kg/min for up to 110 min. Renal blood flow declined early then increased to supra-control levels during infusion. Kidneys perfused at 125 mum/kg/min for 90 min showed patchy to confluent mixtures of cortical necrosis and tubular necrosis. Experimental kidneys invariably showed lower urine osmolality than contralateral controls 48 h after perfusion. Kidneys with necrosis showed depressed creatinine clearance as well. Renal artery infusion of NH4 acetate or intravenous infusion of NaHCO3 during arterial infusion of NH4Cl prevented significant acidosis and caused minimal histological changes, but depression of urine osmolality was not prevented. It is concluded that renal ammonium concentrations up to 40 mum/liter for 90 min does not cause tubular necrosis but does impair urine concentration. Severe tissue damage followed renal exposure to high ammonium concentrations in the presence of metabolic or renal acidosis.

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

    Science.gov (United States)

    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 m(2). RFR ranged between -1.9 and 59.7 with a mean value of 28.9 ± 13.1 ml/min/1.73 m(2). 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 renal susceptibility to different exposures and the consequent risk for AKI.

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

    Science.gov (United States)

    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

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    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

  6. Rosiglitazone Affects Nitric Oxide Synthases and Improves Renal Outcome in a Rat Model of Severe Ischemia/Reperfusion Injury

    Directory of Open Access Journals (Sweden)

    Boris Betz

    2012-01-01

    Full Text Available Background. Nitric oxide (NO-signal transduction plays an important role in renal ischemia/reperfusion (I/R injury. NO produced by endothelial NO-synthase (eNOS has protective functions whereas NO from inducible NO-synthase (iNOS induces impairment. Rosiglitazone (RGZ, a peroxisome proliferator-activated receptor (PPAR-γ agonist exerted beneficial effects after renal I/R injury, so we investigated whether this might be causally linked with NOS imbalance. Methods. RGZ (5 mg/kg was administered i.p. to SD-rats (f subjected to bilateral renal ischemia (60 min. Following 24 h of reperfusion, inulin- and PAH-clearance as well as PAH-net secretion were determined. Morphological alterations were graded by histopathological scoring. Plasma NOx-production was measured. eNOS and iNOS expression was analyzed by qPCR. Cleaved caspase 3 (CC3 was determined as an apoptosis indicator and ED1 as a marker of macrophage infiltration in renal tissue. Results. RGZ improves renal function after renal I/R injury (PAH-/inulin-clearance, PAH-net secretion and reduces histomorphological injury. Additionally, RGZ reduces NOx plasma levels, ED-1 positive cell infiltration and CC3 expression. iNOS-mRNA is reduced whereas eNOS-mRNA is increased by RGZ. Conclusion. RGZ has protective properties after severe renal I/R injury. Alterations of the NO pathway regarding eNOS and iNOS could be an explanation of the underlying mechanism of RGZ protection in renal I/R injury.

  7. Iohexol plasma clearance for measuring glomerular filtration rate in clinical practice and research: a review. Part 1: How to measure glomerular filtration rate with iohexol?

    Science.gov (United States)

    Delanaye, Pierre; Ebert, Natalie; Melsom, Toralf; Gaspari, Flavio; Mariat, Christophe; Cavalier, Etienne; Björk, Jonas; Christensson, Anders; Nyman, Ulf; Porrini, Esteban; Remuzzi, Giuseppe; Ruggenenti, Piero; Schaeffner, Elke; Soveri, Inga; Sterner, Gunnar; Eriksen, Bjørn Odvar; Bäck, Sten-Erik

    2016-01-01

    While there is general agreement on the necessity to measure glomerular filtration rate (GFR) in many clinical situations, there is less agreement on the best method to achieve this purpose. As the gold standard method for GFR determination, urinary (or renal) clearance of inulin, fades into the background due to inconvenience and high cost, a diversity of filtration markers and protocols compete to replace it. In this review, we suggest that iohexol, a non-ionic contrast agent, is most suited to replace inulin as the marker of choice for GFR determination. Iohexol comes very close to fulfilling all requirements for an ideal GFR marker in terms of low extra-renal excretion, low protein binding and in being neither secreted nor reabsorbed by the kidney. In addition, iohexol is virtually non-toxic and carries a low cost. As iohexol is stable in plasma, administration and sample analysis can be separated in both space and time, allowing access to GFR determination across different settings. An external proficiency programme operated by Equalis AB, Sweden, exists for iohexol, facilitating interlaboratory comparison of results. Plasma clearance measurement is the protocol of choice as it combines a reliable GFR determination with convenience for the patient. Single-sample protocols dominate, but multiple-sample protocols may be more accurate in specific situations. In low GFRs one or more late samples should be included to improve accuracy. In patients with large oedema or ascites, urinary clearance protocols should be employed. In conclusion, plasma clearance of iohexol may well be the best candidate for a common GFR determination method. PMID:27679715

  8. Mechanism and specificity of increased amylase/creatinine clearance ratio in pancreatitis.

    Science.gov (United States)

    Marten, A; Beales, D; Elias, E

    1977-09-01

    The amylase/creatinine clearance ratio (Cam/Ccr ratio) was determined in 239 subjects. In 87 hospitalised patients without pancreatic disease (controls) the Cam/Ccr ratio was 3.02 +/- 0.69 (mean +/- ISD). The ratio was above the normal range in all patients with acute pancreatitis but was normal in those with chronic pancreatitis and carcinoma of the pancreas. In 18 patients with choledocholithiasis a raised ratio distinguished those with pancreatitis as assessed independently by the surgeon at laparotomy from those with a macroscopically normal pancreas. Raised Cam/Ccr ratios were also found in diabetics with ketoacidosis and in three patients with fulminant alcoholic liver disease. Though a positive correlation was found between the Cam/Ccr ratio and serum creatinine concentration, abnormally high ratios did not occur in 30 patients with chronic renal failure. A significant increase in Cam/Ccr ratios was produced in six healthy volunteers by intravenous injection of glucagon. However, it is unlikely that hyperglucagonaemia alone accounts for the increased Cam/Ccr ratio seen in acute pancreatitis, as no correlation was found between the clearance ratio and the plasma glucagon concentration in a series of patients. In two other patients in whom excess circulating pancreatic polypeptide was detected the Cam/Ccr ratio was normal. It is concluded that, in view of the sensitivity and relative specificity of finding an increased Cam/Ccr ratio in acute pancreatitis, its determination should be valuable clinically, especially in those cases of hyperamylasaemia where the cause is in doubt. The mechanism whereby the ratio is increased is unknown, and it is unlikely that either glucagon or pancreatic polypeptide is a major factor in its production.

  9. Radioactive Aerosols in the Clinical Study of Pulmonary Clearance

    International Nuclear Information System (INIS)

    The study of pulmonary clearance mechanisms has acquired particular importance owing to the growing pollution of the environment and to the increasing incidence and seriousness of cases of pneumoconiosis. Such research is particularly important in radiopathology because of the frequent occurrence of respiratory radioactive contamination. The authors' aim is to tackle this problem and in particular to study long-term clearance mechanisms. Before starting this work, however, they propose to determine the contamination parameters as accurately as possible. For this purpose they plan to study respiratory function in normal subjects by administering labelled aerosols with well-defined physico-chemical characteristics; the first stage of the investigation is then to observe the kinetics of fixation and clearance in the short term. They describe the installations used for this voluntary contamination which must provide a means of producing the aerosols and administering them in controlled amounts and must also ensure efficient protection of the operators against irradiation arid contamination. The choice of the aerosols is also discussed: this is governed mainly by the nature of the vectors, the particle size and the physical characteristics of the tracers. Finally, the authors outline the detection and measuring techniques which they are using to study contamination kinetics, evaluate contamination burdens and follow the short-term clearance. These data constitute a preliminary basis for the study of long-term clearance. (author)

  10. Screening renal stone formers for distal renal tubular acidosis

    DEFF Research Database (Denmark)

    Osther, P J; Hansen, A B; Røhl, H F

    1989-01-01

    A group of 110 consecutive renal stone formers were screened for distal renal tubular acidosis (RTA) using morning fasting urinary pH (mfUpH) levels followed by a short ammonium chloride loading test in patients with levels above 6.0. In 14 patients (12.7%) a renal acidification defect was noted......; 13 had incomplete and 1 had complete distal RTA. Distal RTA was found particularly in recurrent stone formers (17%), and especially in those with bilateral stone disease, where a distal renal tubular acidification defect was found in 50%. We have been unable to differentiate primary from secondary...... RTA in renal stone formers. Regardless of whether the acidification defect is primary or secondary to stone formation, however, all renal stone formers with distal RTA can expect to benefit from prophylactic alkaline therapy and it is recommended that the screening procedure, which is easy to use...

  11. MR imaging findings of renal infarction induced by renal artery

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jun Woo; Kim, Suck; Kim, Yong Woo; Hu, Jin Sam; Choi, Sang Yoel; Moon, Tae Yong; Lee, Suck Hong; Kim, Byung Su; Lee, Chang Hun [Pusan National Univ., Pusan (Korea, Repulic of). Coll. of Medicine

    1998-02-01

    To assess the usefulness of diffusion-weighted imaging (DWI) in evaluating serial parenchymal changes in renal infarction induced by renal artery ligation, by comparing this with the conventional spin echo technique and correlating the results with the histopathological findings. In 22 rabbits, renal infarction was induced by ligation of the renal artery. Spin-echo T1-weighted imaging (T1WI), turbo spin-echo (TSE) T2-weighted imaging (T2WI), and DWI were performed, using a 1.5-T superconductive unit, at 30 minutes, 1 hour, 2,3,6, 12 and 24 hours, and 2, 3, 7 and 20 days after left renal artery ligation. Changes in signal intensity on T1WI, T2WI, and DWI were correlated with histopathologic findings. Diffusion-weighted imaging is useful for the detection of hyperacute renal infarction, and the apparent diffusion coefficient may provide additional information concerning its evolution. (author). 21 refs., 9 figs.

  12. 99mTc-DTPA Renal Dynamic Imaging Method May Be Unsuitable To Be Used as the Reference Method in Investigating the Validity of CDK-EPI Equation for Determining Glomerular Filtration Rate

    OpenAIRE

    Xie, Peng; Huang, Jian-Min; LIU, XIAO-MEI; Wu, Wei-Jie; Pan, Li-Ping; Lin, Hai-Ying

    2013-01-01

    Objective To compare the measurements of glomerular filtration rate (GFR) determined by 99mTc-diethylene triamine pentaacetic acid (99mTc-DTPA) renal dynamic imaging with those estimated by Chronic Kidney Disease Epidemiology Collaboration (CDK-EPI) equation and to identify a more accurate measurement of GFR of chronic kidney disease (CKD) patients in clinical practice. Methods The GFR was determined simultaneously by 3 methods: (a) dual plasma sample clearance method (tGFR); (b) renal dynami...

  13. Comparative Study between Slow Shock Wave Lithotripsy and Fast Shock Wave Lithotripsy in the Management of Renal Stone

    Directory of Open Access Journals (Sweden)

    AKM Zamanul Islam Bhuiyan

    2013-01-01

    Full Text Available Background: Renal calculi are frequent causes of ureteric colic. Extracorporeal shock wave lithotripsy is the most common treatment of these stones. It uses focused sound waves to break up stones externally. Objective: To compare the efficiency of slow and fast delivery rate of shock waves on stone fragmentation and treatment outcome in patients with renal calculi. Materials and Methods: This prospective study was done in the department of Urology, National Institute of Kidney diseases and Urology, Sher-e-Bangla Nagar, Dhaka from July 2006 to June 2007. Total 90 patients were treated using the Storz Medical Modulith ® SLX lithotripter. Patients were divided into Group A, Group B and Group C – each group having 30 subjects. Group A was selected for extracorporeal shockwave lithotripsy (ESWL by 60 shock waves per minute, Group B by 90 shock waves per minute and Group C by 120 shock waves per minute. Results: Complete clearance of stone was observed in 24 patients in Group A and 13 patients in both Group B and Group C in first session. In Group A only 3 patients needed second session but in Group B and Group C, 12 and 8 patients needed second session. In Group A only one patient needed third session but third session was required for 3 patients in Group B and 5 patients in Group C for complete clearance of stone. In Group A, subsequent sessions were performed under spinal anesthesia and in Group B under sedation and analgesia (p>0.001. Mean number of sessions for full clearance of stones in group A was 1.37 ± 0.85, in Group B was 1.8 ± 0.887 and in Group C was 2.0 ± 1.083. Significant difference was observed in term of sessions among groups (p>0.05. In first follow-up, complete clearance of stones was seen in 24 patients in Group A and 13 in both Group B and Group C. In second follow-up, 3 patients in Group A, 12 in Group B and 8 in Group C showed complete clearance of stones. It was observed that rate of stone clearance was higher in Group A

  14. Effect of metabolic regulation on renal leakiness to dextran molecules in short-term insulin-dependent diabetics

    DEFF Research Database (Denmark)

    Parving, H H; Rutili, F; Granath, K;

    1979-01-01

    were normalized within one to three weeks of effective insulin treatment. This rapid reversibility can hardly be explained by the previously demonstrated enlargement in glomerular size and filtration surface area, since these alterations remain unchanged after more than one month of insulin treatment......Renal clearance of dextran of two ranges of molecular size and glomerular filtration rate (GFR, 51Cr-EDTA) were measured in seven short-term insulin-dependent diabetics (mean age 25 years). Measurements were carried out in the same patient during good and poor metabolic regulation (plasma glucose....... The metabolic regulation did not influence the size-selective properties of the glomerular wall. Therefore, we suggest that the dominating mechanism involved in the GFR and renal dextran clearance alterations is functional, viz. increased filtration pressure....

  15. Renal Medullary Interstitial Cells

    Science.gov (United States)

    Rao, Reena; Hao, Chuan-Ming; Breyer, Matthew D.

    2007-04-01

    Renal medullary interstitial cells (RMICs) are specialized fibroblast-like cells that reside in the renal medulla among the vasa recta, the thin limbs of Henle's loop, and medullary collecting ducts. These cells are characterized by abundant lipid droplets in the cytoplasm. The lipid droplets are composed of triglycerides, cholesterol esters and free long-chain fatty acids, including arachidonic acid. RMICs are also a major site of cyclooxygenase2 (COX-2) expression, and thus a major site of COX-2 derived prostanoid biosynthesis. RMICs are also a potential target of hormones such as angiotensin II and endothelin. The RMIC COX-2 expression and the abundance of lipid droplets change with salt and water intake. These properties of RMICs are consistent with an important role of these cells in modulating physiologic and pathologic processes of the kidney.

  16. Renal subcapsular haematoma: an unusual complication of renal artery stenting

    Institute of Scientific and Technical Information of China (English)

    XIA Dan; CHEN Shan-wen; ZHANG Hong-kun; WANG Shuo

    2011-01-01

    After successful renal artery angioplasty and stent placement, a patient in a fully anticoagulated state developed hypotension and flank pain. Computed tomography (CT) of the abdomen revealed a large renal subcapsular haematoma which was successfully managed conservatively without embolotherapy and surgical intervention. To prevent hemorrhage after renal artery stenting, it is necessary to underscore the importance of reducing the contrast volume and pressure of angiography, controlling systemic blood pressure, and monitoring guide wire position at all times.

  17. Renal aspergillosis secondary to renal intrumentation in immunocompetent patient

    OpenAIRE

    Paul, Sagorika; Singh, Viswajeet; Sankhwar, Satyanarayan; Garg, Manish

    2013-01-01

    Primary renal aspergillosis is a rare urological entity and immune-compromised persons are commonly prone to it. The clinical presentation resembles that of usual bacterial pyelonephritis. We report a case of localised unilateral renal aspergillosis with obstructive uropathy (hypoplastic contralateral kidney) in a young man, occurring after the endoscopic removal of impacted right upper ureteric calculus in a non-immunocompromised patient. In view of deranged renal function, he was initially ...

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

    Science.gov (United States)

    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

  19. Quantitation of renal function using radioisotopic techniques.

    Science.gov (United States)

    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

  20. Hyperparathyroidism of Renal Disease

    Science.gov (United States)

    Yuen, Noah K; Ananthakrishnan, Shubha; Campbell, Michael J

    2016-01-01

    Renal hyperparathyroidism (rHPT) is a common complication of chronic kidney disease characterized by elevated parathyroid hormone levels secondary to derangements in the homeostasis of calcium, phosphate, and vitamin D. Patients with rHPT experience increased rates of cardiovascular problems and bone disease. The Kidney Disease: Improving Global Outcomes guidelines recommend that screening and management of rHPT be initiated for all patients with chronic kidney disease stage 3 (estimated glomerular filtration rate, disease. PMID:27479950

  1. Renal Replacement Therapy

    OpenAIRE

    Zaccaria Ricci; Stefano Romagnoli; Claudio Ronco

    2016-01-01

    During the last few years, due to medical and surgical evolution, patients with increasingly severe diseases causing multiorgan dysfunction are frequently admitted to intensive care units. Therapeutic options, when organ failure occurs, are frequently nonspecific and mostly directed towards supporting vital function. In these scenarios, the kidneys are almost always involved and, therefore, renal replacement therapies have become a common routine practice in critically ill patients with acute...

  2. Renal lithiasis and nutrition

    OpenAIRE

    Prieto Rafel M; Costa-Bauza Antonia; Grases Felix

    2006-01-01

    Abstract Renal lithiasis is a multifactorial disease. An important number of etiologic factors can be adequately modified trough diet, since it must be considered that the urine composition is directly related to diet. In fact, the change of inappropriate habitual diet patterns should be the main measure to prevent kidney stones. In this paper, the relation between different dietary factors (liquid intake, pH, calcium, phosphate, oxalate, citrate, phytate, urate and vitamins) and each type of...

  3. Quantitative scintigraphic parameters for the assessment of renal transplant patients

    Energy Technology Data Exchange (ETDEWEB)

    El Maghraby, T.A.F.; Eck-Smit, B.L.F. van; Pauwels, E.K.J. [Department of Radiology, Division of Nuclear Medicine, Leiden University Medical Centre, P.O. Box 9600, 2300 RC Leiden (Netherlands); Fijter, J.W. de [Department of Nephrology, Leiden University Medical Centre, Leiden (Netherlands)

    1998-10-01

    Radionuclide renal diagnostic studies play an important role in assessing renal allograft function especially in the early post transplant period. In the last two decades various quantitative parameters have been derived from the radionuclide renogram to facilitate and confirm the changes in perfusion and/or function of the kidney allograft. In this review article we discuss the quantitative parameters that have been used to assess graft condition with emphasis on the early post-operative period. These quantitative methods were divided into parameters used for assessing renal graft perfusion and parameters used for evaluating parenchymal function. The blood flow in renal transplants can be quantified by measuring (a) the rate of activity appearance in the kidney graft; (b) the ratio of the integral activity under the transplanted kidney and arterial curves e.g. Hilson's perfusion index and Kircher's kidney/aortic ratio; (c) calculating the renal vascular transit time by deconvolution analysis. The literature overview on these parameters showed us that they have some practical disadvantages of requiring high quality bolus injection and numerical variations related to changes in the site and size of regions of interest. In addition, the perfusion parameter values suffer from significant overlap when various graft pathologies coexist. Quantitative evaluation of the graft parenchymal extraction and excretion was assessed by parameters derived from {sup 123}I/{sup 131}I-OIH,{sup 99m}Tc-DTPA or {sup 99m}Tc-MAG3 renograms. We review in this article a number of parenchymal parameters which include (1) plasma clearance methods like glomerular filtration rate (GFR) and effective renal plasma flow (ERPF); (2) renal transit times such as parenchymal mean transit time, T{sub max}, T{sub 1/2}; (3) parenchymal uptake and excretion indices as the accumulation index, graft uptake capacity at 2 and 10 min, excretion index and elimination index. These indices, however, are

  4. Progress with volunteer studies of nasal deposition and clearance

    International Nuclear Information System (INIS)

    Inhalation is the main route of intake of radioactive material for workers, and can be an important pathway for members of the public following accidental releases of radioactivity to the environment. Much of the inhaled radioactivity initially deposits in the nose, typically over 40% for particles of aerodynamic diameter (dae) greater than 2 μm. However, there is remarkably little information on the clearance from the human nose of particles deposited during inhalation and, until now, none on the clearance of the significant fraction of material that remains in the nasal passage for more than 12 hours. NRPB is conducting a volunteer study to determine the effects of particle size and breathing pattern on particle deposition in, and clearance from, the human nasal passage. This article summarises results obtained to date. (author)

  5. Improving mucociliary clearance in chronic obstructive pulmonary disease.

    Science.gov (United States)

    Bhowmik, Angshu; Chahal, Kamaljeet; Austin, Gillian; Chakravorty, Indranil

    2009-04-01

    Patients with COPD usually experience mucus hypersecretion as a result of airway inflammation and response to noxious stimuli. These in turn lead to worsening airway resistance, impaired airflow, increased work of breathing, dyspnoea and exercise intolerance. Mucus hypersecretion may also lead to increased exacerbations and poor health related quality of life (HRQL). Institution based pulmonary rehabilitation programs incorporating airway clearance techniques have been shown to improve HRQL, reduce dyspnoea and improve exercise tolerance but are often difficult to provide due to restricted accessibility and resource implications. This review examines the current evidence base and best clinical practice in the area of airway clearance. Mechanical devices such as the flutter valves, positive end expiratory pressure and high frequency chest wall oscillation (HFCWO) may be able to provide the benefits of improved airway clearance in the patient's home potentially with reduced demands on healthcare resources.

  6. Pharmacometabonomic Prediction of Busulfan Clearance in Hematopoetic Cell Transplant Recipients.

    Science.gov (United States)

    Navarro, Sandi L; Randolph, Timothy W; Shireman, Laura M; Raftery, Daniel; McCune, Jeannine S

    2016-08-01

    Intravenous (IV) busulfan doses are often personalized to a concentration at steady state (Css) using the patient's clearance, which is estimated with therapeutic drug monitoring. We sought to identify biomarkers of IV busulfan clearance using a targeted pharmacometabonomics approach. A total of 200 metabolites were quantitated in 106 plasma samples, each obtained before IV busulfan administration in hematopoietic cell transplant (HCT) recipients. Both univariate linear regression with false discovery rate (FDR) and pathway enrichment analyses using the Global test were performed. In the univariate analysis, glycine, N-acetylglycine, 2-hydroxyisovaleric acid, creatine, serine, and tyrosine were statistically significantly associated with IV busulfan clearance at P 0.1. Glycine is a component of glutathione, which is conjugated with busulfan via glutathione transferase enzymes. These results demonstrate the potential utility of pharmacometabonomics to inform IV busulfan dosing. Future studies are required to validate these findings. PMID:27350098

  7. Bromosulphophthalein clearance rates in sheep with pyrrolizidine liver damage.

    Science.gov (United States)

    Lanigan, G W; Peterson, J E

    1979-05-01

    Sheep fed a ration containing 50% of dried Heliotropium europaeum showed a marked decline in bromosulphophthalein (BSP) fractional clearance rate during the first 3 months feeding. Thereafter, the response of individual animals varied widely on a time basis, although 3 groups could be identified. In the terminal stages, mean clearance rates were below 20% of initial values, with some sheep showing a decline in excess of 90%. Loss of liver functional capacity was generally much greater than indicated by the degree of damage revealed by histopathology. Thus, a suitably modified test could have considerable prognostic value in the field. In this investigation, all sheep with clearance rates below 0.15 died when exposed to a further period of H. europaeum feeding. PMID:475677

  8. Periodic response of multi-disk rotors with bearing clearances

    Science.gov (United States)

    Kim, Y. B.; Noah, S. T.; Choi, Y. S.

    1991-02-01

    The forced steady state response of a multi-disk rotor system involving a clearance at one of the bearings is determined by using a harmonic balance approach. The impedance method is applied to each of the harmonic steady state components in order to reduce the system to its displacement at the non-linear bearing support. The results reveal the interrelated roles of the bearing clearance, mass eccentricity and side force in producing dangerous subharmonics. The significant effects of the strong non-linearity of a bearing clearance are studied as related to the various system parameters. The results show that the approach developed in this study is computationally superior to numerical integration methods in analyzing multi-disk rotor systems with strong non-linearity.

  9. APPLICATION OF DSM IN OBSTACLE CLEARANCE SURVEYING OF AERODROME

    Directory of Open Access Journals (Sweden)

    X. Qiao

    2016-06-01

    Full Text Available Compared to the wide use of digital elevation model (DEM, digital surface model (DSM receives less attention because that it is composed by not only terrain surface, but also vegetations and man-made objects which are usually regarded as useless information. Nevertheless, these objects are useful for the identification of obstacles around an aerodrome. The primary objective of the study was to determine the applicability of DSM in obstacle clearance surveying of aerodrome. According to the requirements of obstacle clearance surveying at QT airport, aerial and satellite imagery were used to generate DSM, by means of photogrammetry, which was spatially analyzed with the hypothetical 3D obstacle limitation surfaces (OLS to identify the potential obstacles. Field surveying was then carried out to retrieve the accurate horizontal position and height of the obstacles. The results proved that the application of DSM could make considerable improvement in the efficiency of obstacle clearance surveying of aerodrome.

  10. Renal scintigraphy in infants with antenatally diagnosed renal pelvis dilatation

    Directory of Open Access Journals (Sweden)

    Ajdinović Boris

    2008-01-01

    Full Text Available Background/Aim. Ureteropelvic junction obstruction and vesicoureteral reflux are the most frequent entities identified on the basis of antenatal hydronephrosis. The aim of this study was to determine the incidence and pattern of abnormal renal scintigraphy findings in postnatal investigation of children with antenatal hydronephrosis. Methods. Twenty four infants (19 boys and five girls presented with antenatal hydronephrosis and mild to moderate hydronephrosis on ultrasound in newborn period were referred for renal scintigraphy. Ten patients with vesicoureteral reflux documented on micturating cystoureterography underwent 99mTc-DMSA renal scintigraphy and 14 patients were subjected to 99mTc-DTPA scintigraphy. Results. Anteroposterior pelvic diameter on ultrasound ranged from 11 to 24 mm. Renal DMSA scans identified congenital scars in two boys with bilateral reflux of grade V and unilateral reflux of grade III. Relative kidney uptake (RKU less than 40% was found in three, and poor kidney function (RKU less than 10% in two patients. Significant obstruction was shown on DTPA diuretic renal scintigraphy in 6/14 patients. Some slowing in dranaige (T1/2 greater than 10 minutes with no reduction in differential renal function was identified in three patients. Differential renal function less than 10% was obtained in one case. Conclusion. A high percent of abnormal renal scintigraphy findings was obtained. Renal scintigraphy was useful in determination of underlying cause of antenatally detected hydronephrosis.

  11. Renal Replacement Therapy.

    Science.gov (United States)

    Ricci, Zaccaria; Romagnoli, Stefano; Ronco, Claudio

    2016-01-01

    During the last few years, due to medical and surgical evolution, patients with increasingly severe diseases causing multiorgan dysfunction are frequently admitted to intensive care units. Therapeutic options, when organ failure occurs, are frequently nonspecific and mostly directed towards supporting vital function. In these scenarios, the kidneys are almost always involved and, therefore, renal replacement therapies have become a common routine practice in critically ill patients with acute kidney injury. Recent technological improvement has led to the production of safe, versatile and efficient dialysis machines. In addition, emerging evidence may allow better individualization of treatment with tailored prescription depending on the patients' clinical picture (e.g. sepsis, fluid overload, pediatric). The aim of the present review is to give a general overview of current practice in renal replacement therapies for critically ill patients. The main clinical aspects, including dose prescription, modality of dialysis delivery, anticoagulation strategies and timing will be addressed. In addition, some technical issues on physical principles governing blood purification, filters characteristics, and vascular access, will be covered. Finally, a section on current standard nomenclature of renal replacement therapy is devoted to clarify the "Tower of Babel" of critical care nephrology. PMID:26918174

  12. Effect of Internal Clearance on Load Distribution and Life of Radially Loaded Ball and Roller Bearings

    Science.gov (United States)

    Oswald, Fred B.; Zaretsky, Erwin V.; Poplawski, Joseph V.

    2012-01-01

    The effect of internal clearance on radially loaded deepgroove ball and cylindrical roller bearing load distribution and fatigue life was determined for four clearance groups defined in the bearing standards. The analysis was extended to negative clearance (interference) conditions to produce a curve of life factor versus internal clearance. Rolling-element loads can be optimized and bearing life maximized for a small negative operating clearance. Life declines gradually with positive clearance and rapidly with increasing negative clearance. Relationships were found between bearing life and internal clearance as a function of ball or roller diameter, adjusted for load. Results are presented as life factors for radially loaded bearings independent of bearing size or applied load. In addition, a modified Stribeck Equation is presented that relates the maximum rolling-element load to internal bearing clearance.

  13. Mucociliary clearance, airway inflammation and nasal symptoms in urban motorcyclists

    Directory of Open Access Journals (Sweden)

    Tereza C.S. Brant

    2014-01-01

    Full Text Available OBJECTIVES: There is evidence that outdoor workers exposed to high levels of air pollution exhibit airway inflammation and increased airway symptoms. We hypothesized that these workers would experience increased airway symptoms and decreased nasal mucociliary clearance associated with their exposure to air pollution. METHODS: In total, 25 non-smoking commercial motorcyclists, aged 18-44 years, were included in this study. These drivers work 8-12 hours per day, 5 days per week, driving on urban streets. Nasal mucociliary clearance was measured by the saccharine transit test; airway acidification was measured by assessing the pH of exhaled breath condensate; and airway symptoms were measured by the Sino-nasal Outcome Test-20 questionnaire. To assess personal air pollution exposure, the subjects used a passive-diffusion nitrogen dioxide (NO2 concentration-monitoring system during the 14 days before each assessment. The associations between NO2 and the airway outcomes were analyzed using the Mann-Whitney test and the Chi-Square test. Clinicaltrials.gov: NCT01976039. RESULTS: Compared with clearance in healthy adult males, mucociliary clearance was decreased in 32% of the motorcyclists. Additionally, 64% of the motorcyclists had airway acidification and 92% experienced airway symptoms. The median personal NO2 exposure level was 75 mg/m3 for these subjects and a significant association was observed between NO2 and impaired mucociliary clearance (p = 0.036. CONCLUSION: Non-smoking commercial motorcyclists exhibit increased airway symptoms and airway acidification as well as decreased nasal mucociliary clearance, all of which are significantly associated with the amount of exposure to air pollution.

  14. Efficacy of ultrasonography-guided renal biopsy for the evaluation of renal dysfunction following renal transplantation

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Young Jae; Choi, Chul Soon; Min, Seon Jeong; Lee, Gyung Kyu; Lee, Eil Seong; Kang, Ik Won; Bae, Sang Hoon [Hallym University College of Medicine, Chuncheon (Korea, Republic of)

    2003-12-15

    To evaluate the usefulness and complications of renal biopsy under ultrasonography-guidance in renal dysfunction after renal transplantation. Ultrasonography-guided renal biopsy was done in 47 patients with the transplanted kidney. The subjects consisted of 30 males and 17 females, age ranged from 16 to 66 years (average age=38 years). Biopsies were done once in 27 patients, twice in 17 patients, three times in 3 patients, a total of 70 biopsies. The success rate of renal biopsy for the accurate pathologic diagnosis and the incidence and types of complications following biopsy were evaluated. The success rate of renal biopsy for the accurate pathologic diagnosis was 96%(67/70). Pathologic diagnosis included 27 cases of acute rejection (39%), 8 cases of acute tubular necrosis (11%), 4 cases of acute rejection and acute tubular necrosis (6%), 4 cases of cyclosporin toxicity (6%), 4 cases of primary disease recurrence (6%), 4 cases of infection (6%) and others. Complications after renal biopsy included 15 cases of microscopic hematuria (21%), 1 case of gross hematuria with spontaneous cessation and 1 case of life threatening hemorrhage. Ultrasonography-guided renal biopsy is a safe and effective diagnostic method for the evaluation of renal dysfunction following renal transplantation.

  15. Effect of oral N-acetylcysteine on mucus clearance.

    Science.gov (United States)

    Millar, A B; Pavia, D; Agnew, J E; Lopez-Vidriero, M T; Lauque, D; Clarke, S W

    1985-07-01

    Oral N-acetylcysteine has been advocated as a mucolytic agent for use in chronic bronchitis. We have investigated the effects of regular use of this drug at a dose of 200 mg thrice daily for 4 weeks in nine patients with chronic bronchitis on lung function, lung mucociliary clearance and sputum viscosity in a controlled, double-blind, crossover study. No significant differences were found in lung function, mucociliary clearance curves or sputum viscosity following treatment with N-acetylcysteine compared to control or placebo measurements.

  16. Derivation methods for clearance levels applied to reactors

    Energy Technology Data Exchange (ETDEWEB)

    Okoshi, Minoru; Seki, Takeo [Japan Atomic Energy Research Inst., Tokai, Ibaraki (Japan). Tokai Research Establishment

    2001-12-01

    In order to support the discussion by the Nuclear Safety Commission, JAERI derived the unconditional clearance levels for concrete and metal arising from the operation and dismantling of nuclear reactors. The clearance levels of 20 radionuclides were derived from 10 {mu}Sv/y of individual doses by deterministic approach. In this approach, calculation models were established to assess individual doses resulting from 73 exposure pathways related to disposal and recycle/reuse, and realistic parameter values were selected considering Japanese natural and social conditions. The appropriateness of selected parameter values was confirmed by stochastic analyses. (author)

  17. Endothelial dysfunction and increased responses to renal nerve stimulation in rat kidneys during rhabdomyolysis-induced acute renal failure: role of hydroxyl radical.

    Science.gov (United States)

    Cil, Onur; Ertunc, Mert; Gucer, Kadri Safak; Ozaltin, Fatih; Iskit, Alper Bektas; Onur, Rustu

    2012-01-01

    Rhabdomyolysis is an important cause of acute renal failure (ARF) and renal vasoconstriction is the main mechanism in the pathogenesis of ARF. Lipid peroxidation due to hydroxyl radical (.OH) formation and redox cycling of myoglobin also have a role. We investigated the disturbance in renal vascular reactivity to reveal the mechanisms leading to ARF. Female Wistar rats (n = 7) were injected with glycerol (10 mL/kg, 50% in saline) intramuscularly to induce rhabdomyolysis, and then the kidneys were isolated and perfused. We investigated acetylcholine (ACh)-induced endothelium-dependent and papaverine (PAP)-induced endothelium-independent vasodilation responses and renal nerve stimulation (RNS)-induced vasoconstrictions. These were also investigated both in rats which received either .OH scavenger, dimethylthiourea (DMTU: 500 mg/kg before glycerol injection and 125 mg/kg 8 h after glycerol injection, n = 7), or myoglobin redox cycling inhibitor, acetaminophen (ApAP: 100 mg/kg 2 h before glycerol injection and 100 mg/kg each 4 h, and 22 h after glycerol injection, n = 7). ACh-induced responses in glycerol group were decreased (p group. DMTU restored both endothelium-dependent vasodilation and RNS-induced vasoconstriction. ApAP had no effect on vascular responses. Both DMTU and ApAP exerted a partial protective effect in renal histology without restoring serum creatinine and blood urea nitrogen (BUN) levels or creatinine clearance. This study showed that endothelial dysfunction and increased vasoconstriction developed during rhabdomyolysis. .OH plays an important role in the development of these vascular responses. These findings suggest that decreased endothelium-dependent vasodilation and augmented renal sympathetic tonus contribute to the development of renal vasoconstriction during rhabdomyolysis-induced ARF.

  18. Trasplante renal Kidney transplant

    Directory of Open Access Journals (Sweden)

    P. Martín

    2006-08-01

    Full Text Available El trasplante renal es la terapia de elección para la mayoría de las causas de insuficiencia renal crónica terminal porque mejora la calidad de vida y la supervivencia frente a la diálisis. El trasplante renal de donante vivo es una excelente alternativa para el paciente joven en situación de prediálisis porque ofrece mejores resultados. El tratamiento inmunosupresor debe ser individualizado buscando la sinergia inmunosupresora y el mejor perfil de seguridad, y debe adaptarse a las diferentes etapas del trasplante renal. En el seguimiento del trasplante renal hay que tener muy en cuenta los factores de riesgo cardiovascular y los tumores puesto que la muerte del paciente con injerto funcionante es la segunda causa de pérdida del injerto tras el primer año del trasplante. La función alterada del injerto es un factor de mortalidad cardiovascular independiente que requerirá seguimiento y control de todas sus complicaciones para retrasar la entrada en diálisis.The kidney transplant is the therapy of choice for the majority of the causes of chronic terminal kidney insufficiency, because it improves the quality of life and survival in comparison with dialysis. A kidney transplant from a live donor is an excellent alternative for the young patient in a state of pre-dialysis because it offers the best results. Immunosuppressive treatment must be individualised, seeking immunosuppressive synergy and the best safety profile, and must be adapted to the different stages of the kidney transplant. In the follow-up to the kidney transplant, cardiovascular risk factors and tumours must be especially taken into account, given that the death of the patient with a working graft is the second cause of loss of the graft following the first year of the transplant. The altered function of the graft is a factor of independent cardiovascular mortality that will require follow-up and the control of all its complications to postpone the entrance in dialysis.

  19. Fructose-1,6-diphosphate: potential protection in cyclosporine-induced renal impairment.

    Science.gov (United States)

    Cardoso, L R; Santos, O F; Boim, M A; Barros, E G; Ajzen, H; Schor, N

    1996-01-01

    There is evidence that fructose-1,6-diphosphate (FDP) provides protection from hepatic and cardiac toxic-induced damage and ischemic renal insult. To determine if FDP also protects against cyclosporine (CsA)-induced nephrotoxicity, two groups of adult male Wistar rats were studied for whole kidney clearance rates. After two initial control periods, group 1 received only CsA (CsA, n = 8). Group 2 received FDP 350 mg/kg, followed by CsA 50 mg/kg (FDP-CsA, n = 6). In both groups, after a 30-min equilibration period, two additional clearance rates were measured (Post 1 and Post 2). A significant reduction in clearance rates was observed after drug infusion in both groups (approximately 58 and 64% in CsA and FDP-CsA groups, respectively, p < 0.05) with a recovery to control values in the Post 2 period in the FDP-CsA group. These data suggest a protective effect of FDP on CsA-induced renal impairment. PMID:8903863

  20. Types of Renal Calculi and Management Regimen for Chinese Minimally Invasive Percutaneous Nephrolithotomy.

    Science.gov (United States)

    Gu, Si-Ping; Zeng, Guo-Hua; You, Zhi-Yuan; Lu, Yi-Jin; Huang, Yun-Teng; Wang, Qing-Mao; He, Zhao-Hui

    2015-12-01

    Strict selection of patients for minimally invasive percutaneous nephrolithotomy could effectively improve the success rate of surgery. This study aimed to understand the required skills and the efficacy of mini-PCNL in the treatment of five types of upper ureteral calculi. Data collected after X-ray analysis and B mode ultrasound from 633 patients with upper ureteral and renal pelvis calculi who underwent B ultrasound-guided lithotomy was reviewed, including the following: type I, upper ureteral or renal pelvis calculi with moderate hydronephrosis (154 cases); type II, upper ureteral or renal pelvis calculi with severe hydronephrosis (157 cases); type III, upper ureteral or renal pelvis calculi without hydronephrosis (61 cases); type IV, renal pelvis calculi, one or two renal calyx calculi (206 cases); and type V, renal staghorn calculi (55 cases). Operations on 611 cases were successful. The treatment method for five patients was converted to open surgery. Twelve cases were treated by indwelling double-J tube retro-catheterization and extracorporeal shock wave lithotripsy. Five patients gave up the treatment. The rate of calculus clearance was 82.3 %, and the rate of residual calculus was 17.6 %. Selective renal artery embolization was performed in nine cases. Hydropneumothorax occurred in nine cases. No intestinal fistula occurred, and no patient had to undergo nephrectomy. The difficulty and the curative effect of the operation were different because the types of calculi varied. Selection of the procedure based on the different types of calculi could effectively improve the success rate of the procedure, reduce complications, and shorten the learning curve.

  1. Types of Renal Calculi and Management Regimen for Chinese Minimally Invasive Percutaneous Nephrolithotomy.

    Science.gov (United States)

    Gu, Si-Ping; Zeng, Guo-Hua; You, Zhi-Yuan; Lu, Yi-Jin; Huang, Yun-Teng; Wang, Qing-Mao; He, Zhao-Hui

    2015-12-01

    Strict selection of patients for minimally invasive percutaneous nephrolithotomy could effectively improve the success rate of surgery. This study aimed to understand the required skills and the efficacy of mini-PCNL in the treatment of five types of upper ureteral calculi. Data collected after X-ray analysis and B mode ultrasound from 633 patients with upper ureteral and renal pelvis calculi who underwent B ultrasound-guided lithotomy was reviewed, including the following: type I, upper ureteral or renal pelvis calculi with moderate hydronephrosis (154 cases); type II, upper ureteral or renal pelvis calculi with severe hydronephrosis (157 cases); type III, upper ureteral or renal pelvis calculi without hydronephrosis (61 cases); type IV, renal pelvis calculi, one or two renal calyx calculi (206 cases); and type V, renal staghorn calculi (55 cases). Operations on 611 cases were successful. The treatment method for five patients was converted to open surgery. Twelve cases were treated by indwelling double-J tube retro-catheterization and extracorporeal shock wave lithotripsy. Five patients gave up the treatment. The rate of calculus clearance was 82.3 %, and the rate of residual calculus was 17.6 %. Selective renal artery embolization was performed in nine cases. Hydropneumothorax occurred in nine cases. No intestinal fistula occurred, and no patient had to undergo nephrectomy. The difficulty and the curative effect of the operation were different because the types of calculi varied. Selection of the procedure based on the different types of calculi could effectively improve the success rate of the procedure, reduce complications, and shorten the learning curve. PMID:27011473

  2. Taurine and the renal system

    OpenAIRE

    Chesney Russell W; Han Xiaobin; Patters Andrea B

    2010-01-01

    Abstract Taurine participates in a number of different physiologic and biologic processes in the kidney, often reflected by urinary excretion patterns. The kidney is key to aspects of taurine body pool size and homeostasis. This review will examine the renal-taurine interactions relative to ion reabsorption; renal blood flow and renal vascular endothelial function; antioxidant properties, especially in the glomerulus; and the role of taurine in ischemia and reperfusion injury. In addition, ta...

  3. The epidemiology of renal trauma

    OpenAIRE

    Voelzke, Bryan B.; Leddy, Laura

    2014-01-01

    Introduction Nonoperative and minimally invasive management techniques for both blunt and penetrating renal trauma have become standard of care over the past decades. We sought to examine the modern epidemiology of renal trauma over the past decade. Methods A systematic review of PubMed from the past decade was conducted to examine adult and pediatric renal trauma. A total of 605 articles were identified. Of these, 15 adult and 5 pediatric articles met our a priori search criteria. Results Th...

  4. Padronização do método para cálculo da captação renal absoluta do99mTc-DMSA em cria Standardization of a method to calculate absolute renal uptake of 99mTc-DMSA in children

    Directory of Open Access Journals (Sweden)

    Carla Rachel Ono

    2006-02-01

    Full Text Available OBJETIVO: O trabalho teve por objetivo padronizar o método e estabelecer valores normais da captação renal absoluta do99mTc-DMSA em crianças. MATERIAIS E MÉTODOS: Vinte e duas crianças (idade de 7 meses a 10 anos; média de 4,5 anos sem doença renal prévia foram submetidas a cintilografia renal estática com 99mTc-DMSA. Dezoito apresentavam ultra-sonografia, uretrocistografia miccional, "clearance" de creatinina e padrão visual da cintilografia renal estática normais. Quatro crianças foram excluídas por não terem completado ou por apresentarem redução do "clearance" de creatinina. A captação absoluta de DMSA (DMSA-Abs foi calculada como a porcentagem da atividade administrada retida em cada rim após seis horas da administração do radiofármaco. RESULTADOS: Os valores de DMSA-Abs foram de 21,8% ± 3,2% para o rim direito e de 23,1% ± 3,3% para o rim esquerdo. Os valores da captação absoluta não mostraram correlação com a idade dos pacientes estudados, apesar da tendência de aumento do "clearance" de creatinina com a idade. CONCLUSÃO: A definição de valores normais da DMSA-Abs permite o emprego deste parâmetro na avaliação inicial e acompanhamento de doenças renais, principalmente em pacientes com acometimento bilateral ou com rim único (nos quais a função diferencial direita X esquerda tem valor limitado.OBJECTIVE: To standardize a method and determine normal values for absolute renal uptake of 99mTc-DMSA in children with normal creatinine clearance. MATERIALS AND METHODS: Twenty-two children (between 7 months and 10 years of age; mean 4.5 years without clinical evidence of renal disease were studied using 99mTc-DMSA scintigraphy. Eighteen had normal renal ultrasonography, micturating urethrocystography, creatinine clearance and visual interpretation of the scintigraphy with 99mTc-DMSA. Four children were excluded, one with incomplete creatinine clearance and three due to reduction in the creatinine clearance

  5. The prognostic importance of creatinine clearance after acute myocardial infarction

    DEFF Research Database (Denmark)

    Sørensen, C R; Brendorp, B; Rask-Madsen, C;

    2002-01-01

    AIMS: The purpose of this study was to assess renal dysfunction as an independent predictor of mortality after acute myocardial infarction. METHODS: The study population was 6252 patients with a myocardial infarction admitted alive from 1990 to 1992. The mortality status was obtained after at least.......9-1.3) respectively. CONCLUSION: Renal dysfunction is an important risk factor after acute myocardial infarction. When the risk is adjusted for available competing risk factors only severely reduced renal function is associated with an important and independent risk of mortality after acute myocardial infarction...

  6. Technology insight: Innovative options for end-stage renal disease--from kidney refurbishment to artificial kidney.

    Science.gov (United States)

    Braam, Branko; Verhaar, Marianne C; Blankestijn, Peter; Boer, Walther H; Joles, Jaap A

    2007-10-01

    The steadily growing number of patients with chronic kidney disease who will eventually develop end-stage renal disease, together with the qualitative limitations of currently available renal replacement therapies, have triggered the exploration of innovative strategies for renal replacement therapy and for salvage of renal function. Currently, new hemodialysis modalities and membranes are being used with the aim of increasing clearance of uremic toxins to afford better metabolic control. In addition to these conventional approaches, there are four innovative potential solutions to the problem of replacing renal function when kidneys fail. The first is a small, implantable device with the potential to be supplemented with human cells ('artificial kidney'). The second involves restoration of the damaged kidney by harnessing recent advances in stem-cell technology and knowledge of developmental programing ('refurbished kidney'). The third is (partially) growing a kidney in vitro with the use of therapeutic cloning ('cultured kidney'). The fourth innovative solution involves the use of other organs to replace various renal functions ('distributed kidney'). In this article we review the efforts that have been made to improve renal replacement therapies, and explore innovative approaches. We will not cover all potential solutions in detail. Rather, we aim to indicate directions of future endeavor and arouse enthusiasm in clinicians and scientists for exploration of these exciting avenues.

  7. Renal myxoma: a case report

    Directory of Open Access Journals (Sweden)

    Carlos Henrique C Souza

    2015-04-01

    Full Text Available Myxomas are rare tumors that can appear in many anatomical locations. There are only 14 cases of renal involvement documented in the literature. This article reports a case of renal myxoma in an elderly woman with recurrent cystitis. After five years of follow-up, the computed tomography (CT revealed a large solid tumor mass in the left kidney. Tumor resection was performed preserving the affected kidney with histopathological diagnosis of renal myxoma. The objective of this study is to report a rare case of renal myxoma, emphasizing the importance of the differential diagnosis from other benign and malignant mesenchymal tumors.

  8. CT features of renal infarction

    Energy Technology Data Exchange (ETDEWEB)

    Suzer, Okan; Shirkhoda, Ali; Jafri, S. Zafar; Madrazo, Beatrice L.; Bis, Kostaki G.; Mastromatteo, James F

    2002-10-01

    Purpose: To demonstrate the different patterns of renal infarction to avoid pitfalls. To present 'flip-flop enhancement' pattern in renal infarction. Materials and methods: Retrospective review of a total of 41 renal infarction in 37 patients were done. These patients underwent initial CT and the diagnosis of renal infarction was confirmed with either follow up CT or at surgery. Results: Twenty-three patients had wedge-shaped focal infarcts, nine patients had global and five patients had multifocal infarcts of the kidneys. Cortical rim sign was seen predominantly with global infarcts. In five patients, a 'flip-flop enhancement' pattern was observed. In two patients, planned renal biopsies due to tumefactive renal lesions were cancelled because of 'flip-flop enhancement' pattern on follow up CTs. Conclusion: Although most of our cases were straightforward for the diagnosis of renal infarction, cases with tumefactive lesions and global infarctions without the well-known cortical rim sign were particularly challenging. We describe a new sign, flip-flop enhancement pattern, which we believe solidified the diagnosis of renal infarction in five of our cases. The authors recommend further investigations for association of flip-flop enhancement and renal infarction.

  9. Sporotrichosis in Renal Transplant Patients

    Directory of Open Access Journals (Sweden)

    Paulo Gewehr

    2013-01-01

    Full Text Available The current report describes two renal transplant recipients who presented with sporotrichosis. In addition, the authors review the general aspects of sporotrichosis in renal transplant recipients reported in the literature. Sporotrichosis is a rare fungal infection in transplant patients and has been reported primarily in renal transplant recipients not treated with antifungal prophylaxis. Extracutaneous forms of sporotrichosis without skin manifestations and no previous history of traumatic injuries have been described in such patients and are difficult to diagnose. Renal transplant recipients with sporotrichosis described in the present report were successfully treated with antifungal therapy including amphotericin B deoxycholate, lipid amphotericin B formulations, fluconazole and itraconazole.

  10. 轴承游隙计算分析%Analysis and calculation of bearing clearance

    Institute of Scientific and Technical Information of China (English)

    郭玉朋

    2014-01-01

    This paper analyzes the original common bearing clearance, installation clearance,clearance work,what used to solve bearing in C0,C3 clearance clearance work group size,select the project for future reference bearing clearance.%本文通过分析常用轴承的原始游隙,安装游隙,工作游隙,来求解一下常用轴承在C0,C3游隙组中的工作游隙的大小,作为以后项目选取轴承游隙的参考。

  11. Renal cirsoid arteriovenous malformation masquerading as neoplasia.

    Science.gov (United States)

    Silverthorn, K; George, D

    1988-12-01

    A woman with renal colic and microscopic hematuria had filling defects in the left renal collecting system detected on excretory urography. A nephrectomy, performed because of suspected malignancy, might have been averted by renal angiography.

  12. Mechanisms controlling renal hemodynamics and electrolyte excretion during amino acids

    Energy Technology Data Exchange (ETDEWEB)

    Woods, L.L.; Mizelle, H.L.; Montani, J.P.; Hall, J.E.

    1986-08-01

    Our purpose was to investigate the mechanisms by which increased plasma amino acids elevate renal blood flow (RBF) and glomerular filtration rate (GFR). Since transport of amino acids and Na is linked in the proximal tubule, the authors hypothesized that increased amino acids might stimulate proximal tubular Na reabsorption (PR/sub Na/) and thus increase RBF and GFR by a macula densa feedback mechanism. A solution of four amino acids (Ala, Ser, Gly, Pro) was infused intravenously into anesthetized dogs with normal kidneys (NK) and with kidneys in which the tubuloglomerular feedback mechanism was blunted by lowering renal artery pressure (LPK) or blocked by making the kidneys nonfiltering (NFK). In NK, RBF and GFR increased by 35 +/- 4% and 30 +/- 7% after 90 min of amino acid infusion, while PR/sub Na/ (estimated from lithium clearance) and O2 consumption increased by 31 +/- 5% and 29 +/- 5% and distal Na delivery remained relatively constant. Autoregulation of RBF and GFR in response to step deceases in renal artery pressure was impaired during amino acids in NK. The hemodynamic responses to amino acids were abolished in LPK and NFK. Infusion of the nonmetabolized -aminoisobutyric acid into NK produced changes in renal hemodynamics that were similar to the responses observed with the four metabolizable amino acids. These data are consistent with the hypothesis that elevation of plasma amino acids increases RBF and GFR by a mechanism that requires an intact macula densa feedback. Metabolism of the amino acids does not appear to be necessary for these changes to occur.

  13. Effects of oral enalapril and verapamil on dialysis adequacy and solute clearance in chronic ambulatory peritoneal dialysis

    Directory of Open Access Journals (Sweden)

    Shahnaz Atabak

    2013-01-01

    Full Text Available Peritoneal dialysis offers several advantages such as better clearance of intermediate/large molecules and better preservation of renal residual function when compared with hemodialysis. However, dialysis adequacy is one of the subjects of concern of this modality. There are some drugs that are capable of influencing solute transport in the peritoneum, such as acetyle co-enzyme inhibitors (ACE-I medications and calcium channel blockers. Captopril and Verapamil are often mentioned, but their use has shown varying conclusions and initial studies were performed with the intra-peritoneal administration of these drugs and there are only a few studies on the effect of the oral administration of these drugs. This study was undertaken with the aim to evaluate the effects of oral administration of Verapamil and Enalapril among continuous ambulatory peritoneal dialysis (CAPD patients. The results of this study showed that Verapamil and Enalapril do not have any effects on glucose, creatinine, sodium, potassium and urea clearance (during the 4-h peritoneal equilibration test (PET test. However, it was shown that Enalapril significantly increased the peritoneal urea Kt/V and caused a meaningful decrease in the diastolic and mean blood pressures. Therefore, we feel that Enalapril may be administered as an anti-hypertensive medication of choice in CAPD patients, which can also result in better dialysis adequacy. However, further studies with larger sample sizes are needed in the future.

  14. Amino acids protects against renal ischemia-reperfusion injury and attenuates renal endothelin-1 disorder in rats

    Institute of Scientific and Technical Information of China (English)

    谢立平; 郑祥毅; 秦杰; 童炎岳

    2004-01-01

    Objective: To investigate nephroprotective effects of a mixture of 8 L-amino acids on renal ischemia-reperfusion injury and its effects on renal endothelin-1 (ET-1). Methods: The mixture of 8 L-amino acids includes glycine, alanine, threonine, serine, valine, leucine, isoleucine and proline. Acute ischemic renal injury was induced by clamping renal pedicle for 45 minutes in rats. Sixty male Sprague-Dawiey rats were randomly divided into 3 groups: a sham-operated group ( Group A, n = 8), a control group (Group B, n = 26 ) and an amino acid- treated group (Group C, n = 26 ). Amino acids were infused at a rate of 1 mi · 100g-1 · h-1 I hour before ischemia and during 3 hours of the whole reperfusion. The serum creatinine values, BUN levels, creatiulne clearance, urine sodium & potassium excretion, urine lactate dehydrogenase (LDH),the rate of urine flow and histological examination were measured. Renal ET-1 levels were assayed with radioimmunological assay (RIA) Results: The creatinine clearance was 471.0 μl/min ± 121.5 pi/main in Group C and 227.0 μl/min ± 27.0 μl/min in Group B 3 hours after reperfnsion, P < 0.01 ). The urine flow rate was 63.6 pi/min ± 15.2 μl/min in Group C and 24.3 μl/min ± 7.7 μl/minin Group B, P < 0.01 ) 1.5 hours after reperfusion. The serum creatinine was 85.0 μl/min ± 7.7 μmol/L and BUN oncentration11.4 mmol/L ±3.9 mmol/L in Group C and 112.7 μmol/L ± 19.5 μmol/L and 20.7 mmol/L ± 6.6 mmol/L respectively in Group B after 24 hours of reperfusion (P < 0.05) . The mean histological score by standards of Paller in kidneys was 108.7 ± 15.7 in Group C, and 168.8 ± 14.8 in Group B (P < 0.01 ). The renal ET-1 levels 15 minute and 3 hours after reperfusion were 7.2 pg/mg ± 0.8 pg/mg and 9.6 pg/ml ± 1.0 pg/ml in Group C , and 10.1 pg/ml ± 2.8 pg/ml and 13.0 pg/ml ± 2.7 pg/mi in Group B ( P < 0.01). Conclusions: The mixture of 8 L-amino acids can provide remarkable protection against renal isehemia- reperfusion injury

  15. Management of post-biopsy renal allograft arteriovenous fistulas with selective arterial embolization: immediate and long-term outcomes

    Energy Technology Data Exchange (ETDEWEB)

    Loffroy, R. [Department of Diagnostic and Interventional Radiology, University of Dijon School of Medicine, Bocage Teaching Hospital, Dijon (France)], E-mail: loffroy.romaric@neuf.fr; Guiu, B.; Lambert, A. [Department of Diagnostic and Interventional Radiology, University of Dijon School of Medicine, Bocage Teaching Hospital, Dijon (France); Mousson, C.; Tanter, Y. [Department of Nephrology and Renal Transplantation (France); Martin, L. [Department of Pathology, University of Dijon School of Medicine, Bocage Teaching Hospital, Dijon (France); Cercueil, J.-P.; Krause, D. [Department of Diagnostic and Interventional Radiology, University of Dijon School of Medicine, Bocage Teaching Hospital, Dijon (France)

    2008-06-15

    Aim: To evaluate the outcomes after transcatheter embolization of percutaneous biopsy-related arteriovenous fistulas in renal allografts. Materials and methods: All post-biopsy renal-transplant vascular injuries referred for embolization between June 1999 and October 2006 were reviewed retrospectively. There were six male and six female patients with a mean age of 49.8 years (range 25-67 years); nine patients were symptomatic, three asymptomatic. Colour Doppler ultrasound (CDUS) and angiography showed one intra-renal arteriovenous fistula in 10 patients and two in two patients, combined with a pseudoaneurysm in six patients. Superselective embolization using a single catheter or coaxial microcatheter was performed with 0.035'' coils or 0.018''microcoils, respectively, in all 12 cases. 24-h creatinine clearance values before (the day of biopsy) and after (7-14 days; 3 months) the procedure were compared using the Wilcoxon signed-rank test. Physical examination and CDUS were performed after 1, 6, and 12 months, and yearly thereafter. Mean follow-up was 33.6 months. Results: Complete definitive occlusion of the fistula was achieved consistently with a single procedure. No procedure-related complications occurred. Renal infarction was minor in all patients (0-10% in nine and 10-20% in three). Symptoms resolved completely. Creatinine clearance values obtained before and after embolization were not statistically different (p = 0.168;.889 respectively). No late recurrences were reported. Conclusion: Transcatheter embolization with coaxial or single-catheter techniques was effective and safe for treating post-biopsy arteriovenous fistulas in renal transplants. The loss of renal parenchyma was minimal and no mid-term deterioration of allograft function was noted. The long-term survival of the renal allograft seemed to be not affected by embolization.

  16. Renal blood flow in experimental septic acute renal failure

    NARCIS (Netherlands)

    Langenberg, C.; Wan, L.; Egi, M.; May, C. N.; Bellomo, R.

    2006-01-01

    Reduced renal blood flow (RBF) is considered central to the pathogenesis of septic acute renal failure (ARF). However, no controlled experimental studies have continuously assessed RBF during the development of severe septic ARF. We conducted a sequential animal study in seven female Merino sheep. F

  17. Renal vein oxygen saturation in renal artery stenosis

    DEFF Research Database (Denmark)

    Nielsen, K; Rehling, M; Henriksen, Jens Henrik Sahl

    1992-01-01

    Renal vein oxygen-saturation was measured in 56 patients with arterial hypertension and unilateral stenosis or occlusion of the renal artery. Oxygen-saturation in blood from the ischaemic kidney (84.4%, range 73-93%) was significantly higher than that from the 'normal' contralateral kidney (81...

  18. The renal scan in pregnant renal transplant patients

    International Nuclear Information System (INIS)

    With the greater frequency of renal transplant surgery, more female pts are becoming pregnant and carrying to term. In the renal allograft blood vessels and ureter may be compressed resulting in impaired renal function and/or, hypertension. Toxemia of pregnancy is seen more frequently than normal. Radionuclide renal scan monitoring may be of significant value in this high risk obstetrical pt. After being maintained during the pregnancy, renal function may also deteriorate in the post partum period. 5 pregnant renal transplant pts who delivered live babies had renal studies with Tc-99m DTPA to assess allograft perfusion and function. No transplanted kidney was lost during or after pregnancy as a result of pregnancy. No congenital anomalies were associated with transplant management. 7 studies were performed on these 5 pts. The 7 scans all showed the uterus/placenta. The bladder was always distorted. The transplanted kidney was rotated to a more vertical position in 3 pts. The radiation dose to the fetus is calculated at 0.024 rad/mCi administered. This study demonstrates the anatomic and physiologic alterations expected in the transplanted kidney during pregnancy when evaluated by renal scan and that the radiation burden may be acceptable in management of these pts

  19. The renal scan in pregnant renal transplant patients

    Energy Technology Data Exchange (ETDEWEB)

    Goldstein, H.A.; Ziessman, H.A.; Fahey, F.H.; Collea, J.V.; Alijani, M.R.; Helfrich, G.B.

    1985-05-01

    With the greater frequency of renal transplant surgery, more female pts are becoming pregnant and carrying to term. In the renal allograft blood vessels and ureter may be compressed resulting in impaired renal function and/or, hypertension. Toxemia of pregnancy is seen more frequently than normal. Radionuclide renal scan monitoring may be of significant value in this high risk obstetrical pt. After being maintained during the pregnancy, renal function may also deteriorate in the post partum period. 5 pregnant renal transplant pts who delivered live babies had renal studies with Tc-99m DTPA to assess allograft perfusion and function. No transplanted kidney was lost during or after pregnancy as a result of pregnancy. No congenital anomalies were associated with transplant management. 7 studies were performed on these 5 pts. The 7 scans all showed the uterus/placenta. The bladder was always distorted. The transplanted kidney was rotated to a more vertical position in 3 pts. The radiation dose to the fetus is calculated at 0.024 rad/mCi administered. This study demonstrates the anatomic and physiologic alterations expected in the transplanted kidney during pregnancy when evaluated by renal scan and that the radiation burden may be acceptable in management of these pts.

  20. Tissue biodistribution and blood clearance rates of intravenously administered carbon nanotube radiotracers

    Science.gov (United States)

    Singh, Ravi; Pantarotto, Davide; Lacerda, Lara; Pastorin, Giorgia; Klumpp, Cédric; Prato, Maurizio; Bianco, Alberto; Kostarelos, Kostas

    2006-02-01

    Carbon nanotubes (CNT) are intensively being developed for biomedical applications including drug and gene delivery. Although all possible clinical applications will require compatibility of CNT with the biological milieu, their in vivo capabilities and limitations have not yet been explored. In this work, water-soluble, single-walled CNT (SWNT) have been functionalized with the chelating molecule diethylentriaminepentaacetic (DTPA) and labeled with indium (111In) for imaging purposes. Intravenous (i.v.) administration of these functionalized SWNT (f-SWNT) followed by radioactivity tracing using gamma scintigraphy indicated that f-SWNT are not retained in any of the reticuloendothelial system organs (liver or spleen) and are rapidly cleared from systemic blood circulation through the renal excretion route. The observed rapid blood clearance and half-life (3 h) of f-SWNT has major implications for all potential clinical uses of CNT. Moreover, urine excretion studies using both f-SWNT and functionalized multiwalled CNT followed by electron microscopy analysis of urine samples revealed that both types of nanotubes were excreted as intact nanotubes. This work describes the pharmacokinetic parameters of i.v. administered functionalized CNT relevant for various therapeutic and diagnostic applications. nanomedicine | blood circulation half-life | drug delivery | pharmacokinetics | nanotoxicology

  1. CXCR1-mediated neutrophil degranulation and fungal killing promote Candida clearance and host survival.

    Science.gov (United States)

    Swamydas, Muthulekha; Gao, Ji-Liang; Break, Timothy J; Johnson, Melissa D; Jaeger, Martin; Rodriguez, Carlos A; Lim, Jean K; Green, Nathaniel M; Collar, Amanda L; Fischer, Brett G; Lee, Chyi-Chia Richard; Perfect, John R; Alexander, Barbara D; Kullberg, Bart-Jan; Netea, Mihai G; Murphy, Philip M; Lionakis, Michail S

    2016-01-20

    Systemic Candida albicans infection causes high morbidity and mortality and is now the leading cause of nosocomial bloodstream infection in the United States. Neutropenia is a major risk factor for poor outcome in infected patients; however, the molecular factors that mediate neutrophil trafficking and effector function during infection are poorly defined. Using a mouse model of systemic candidiasis, we found that the neutrophil-selective CXC chemokine receptor Cxcr1 and its ligand, Cxcl5, are highly induced in the Candida-infected kidney, the target organ in the model. To investigate the role of Cxcr1 in antifungal host defense in vivo, we generated Cxcr1(-/-) mice and analyzed their immune response to Candida. Mice lacking Cxcr1 exhibited decreased survival with enhanced Candida growth in the kidney and renal failure. Increased susceptibility of Cxcr1(-/-) mice to systemic candidiasis was not due to impaired neutrophil trafficking from the blood into the infected kidney but was the result of defective killing of the fungus by neutrophils that exhibited a cell-intrinsic decrease in degranulation. In humans, the mutant CXCR1 allele CXCR1-T276 results in impaired neutrophil degranulation and fungal killing and was associated with increased risk of disseminated candidiasis in infected patients. Together, our data demonstrate a biological function for mouse Cxcr1 in vivo and indicate that CXCR1-dependent neutrophil effector function is a critical innate protective mechanism of fungal clearance and host survival in systemic candidiasis. PMID:26791948

  2. Amylase:creatinine clearance ratios, serum amylase, and lipase after operations with cardiopulmonary bypass.

    Science.gov (United States)

    Smith, C R; Schwartz, S I

    1983-09-01

    Forty-two adults who underwent cardiac operations were studied prospectively for evidence of clinical or subclinical pancreatitis. Clinically detectable pancreatitis was not seen. Serum amylase and lipase levels did not change significantly following operation. The amylase:creatinine clearance ratio (ACCR) immediately following operation was abnormally elevated in 31% of the samples obtained, and the mean ACCR increased from 2.08 +/- 1.85% before operation to 6.2% +/- 6.77% (P less than 0.05). An abnormally elevated ACCR was most often associated with a low urine creatinine concentration. The mean urine creatinine level decreased significantly from 78 +/- 53 mg/dl before operation to 38 +/- 49 mg/dl immediately following operation (P less than 0.02), and 73% of the samples obtained at that time had an abnormally low urine creatinine level (P less than 0.01). The abnormalities observed in ACCR and urine creatinine could not be related to any of several variables presumed to reflect the degree of perioperative physiologic stress, nor could they be related to postoperative hemodynamic performance. It was concluded that ACCR rises following cardiac operation because of perioperative changes in renal function, and not as a reflection of subclinical pancreatic injury.

  3. Amylase:creatinine clearance ratios, serum amylase, and lipase after operations with cardiopulmonary bypass.

    Science.gov (United States)

    Smith, C R; Schwartz, S I

    1983-09-01

    Forty-two adults who underwent cardiac operations were studied prospectively for evidence of clinical or subclinical pancreatitis. Clinically detectable pancreatitis was not seen. Serum amylase and lipase levels did not change significantly following operation. The amylase:creatinine clearance ratio (ACCR) immediately following operation was abnormally elevated in 31% of the samples obtained, and the mean ACCR increased from 2.08 +/- 1.85% before operation to 6.2% +/- 6.77% (P less than 0.05). An abnormally elevated ACCR was most often associated with a low urine creatinine concentration. The mean urine creatinine level decreased significantly from 78 +/- 53 mg/dl before operation to 38 +/- 49 mg/dl immediately following operation (P less than 0.02), and 73% of the samples obtained at that time had an abnormally low urine creatinine level (P less than 0.01). The abnormalities observed in ACCR and urine creatinine could not be related to any of several variables presumed to reflect the degree of perioperative physiologic stress, nor could they be related to postoperative hemodynamic performance. It was concluded that ACCR rises following cardiac operation because of perioperative changes in renal function, and not as a reflection of subclinical pancreatic injury. PMID:6193594

  4. Mucociliary and cough clearance as a biomarker for therapeutic development

    DEFF Research Database (Denmark)

    Bennett, William D; Daviskas, Evangelia; Hasani, Amir;

    2010-01-01

    A workshop/symposium on “Mucociliary and Cough Clearance (MCC/CC) as a Biomarker for Therapeutic Development” was held on October 21–22, 2008, in Research Triangle Park, NC, to discuss the methods for measurement of MCC/CC and how they may be optimized for assessing new therapies designed...

  5. Early clearance of Mycobacterium tuberculosis: a new frontier in prevention

    NARCIS (Netherlands)

    Verrall, A.J.; Netea, M.G.; Alisjahbana, B.; Hill, P.C.; Crevel, R. van

    2014-01-01

    Early clearance (EC) is the successful eradication of inhaled Mycobacterium tuberculosis before an adaptive immune response develops. Evidence for EC comes from case contact studies that consistently show that a proportion of heavily exposed individuals do not develop M. tuberculosis infection. Furt

  6. 46 CFR 61.20-23 - Tailshaft clearance; bearing weardown.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 2 2010-10-01 2010-10-01 false Tailshaft clearance; bearing weardown. 61.20-23 Section...; bearing weardown. (a) Water lubricated bearings, other than rubber, must be rebushed as follows: (1) Where the propelling machinery is located amidship, the after stern tube bearing must be rebushed when it...

  7. Mucociliary clearance, airway inflammation and nasal symptoms in urban motorcyclists

    OpenAIRE

    Brant, Tereza C S; Yoshida, Carolina T; Tomas de S. Carvalho; Nicola, Marina L; Jocimar. A. Martins; Lays M. Braga; Regiani C. de Oliveira; Vilma Leyton; Carmen S. de André; Saldiva, Paulo H. N.; Rubin, Bruce K.; Naomi K. Nakagawa

    2014-01-01

    OBJECTIVES: There is evidence that outdoor workers exposed to high levels of air pollution exhibit airway inflammation and increased airway symptoms. We hypothesized that these workers would experience increased airway symptoms and decreased nasal mucociliary clearance associated with their exposure to air pollution. METHODS:...

  8. Influence of clearance model on numerical simulation of centrifugal pump

    Science.gov (United States)

    Wang, Z.; Gao, B.; Yang, L.; Du, W. Q.

    2016-05-01

    Computing models are always simplified to save the computing resources and time. Particularly, the clearance that between impeller and pump casing is always ignored. But the completer model is, the more precise result of numerical simulation is in theory. This paper study the influence of clearance model on numerical simulation of centrifugal pump. We present such influence via comparing performance, flow characteristic and pressure pulsation of two cases that the one of two cases is the model pump with clearance and the other is not. And the results show that the head decreases and power increases so that efficiency decreases after computing with front and back cavities. Then no-leakage model would improve absolute velocity magnitude in order to reach the rated flow rate. Finally, more disturbance induced by front cavity flow and wear-ring flow would change the pressure pulsation of impeller and volute. The performance of clearance flow is important for the whole pump in performance, flow characteristic, pressure pulsation and other respects.

  9. 19 CFR 4.61 - Requirements for clearance.

    Science.gov (United States)

    2010-04-01

    ... either on the Customs Form 1300 or by approved electronic means. Customs port directors may permit the.... Customs may take local resources into consideration in allowing clearance to be transacted on board... thereto by any means of communication that is satisfactory to the local Customs port director, and...

  10. Modifications of lung clearance mechanisms by acute influenza A infection

    International Nuclear Information System (INIS)

    Four volunteers with naturally acquired, culture-proved influenza A infection inhaled a radiolabeled aerosol to permit investigation of lung mucociliary clearance mechanisms during and after symptomatic illness. Mucus transport in the trachea was undetectable when monitored with an external multidetector probe within 48 hours of the onset of the illness, but was found at a normal velocity by 1 week in three of the four subjects. In two volunteers who coughed 23 to 48 times during the 4.5-hour observation period, whole lung clearance was as fast within the first 48 hours of illness as during health 3 months later in spite of the absence of measurable tracheal mucus transport. Conversely, in spite of the return 1 week later of mucus transport at velocities expected in the trachea, whole lung clearance for the 4.5-hour period was slowed in two volunteers who coughed less than once an hour. The data offer evidence that cough is important in maintaining lung clearance for at least several days after symptomatic influenza A infection when other mechanisms that depend on ciliary function are severely deficient

  11. Effect of lindane on the clearance rate of Daphnia magna

    NARCIS (Netherlands)

    Hartgers, E.M.; Heugens, E.W.; Deneer, J.W.

    1999-01-01

    The impact of the insecticide lindane (%-hexachlorocyclohexane) on the clearance rate (CR) of Daphnia magna was investigated using artificial beads. CR (24-h EC50: 65 7g Lm1) was found to be a more sensitive endpoint than acute lethality for D. magna (48-h LC50: 516 7g Lm1). The onset of the effect

  12. 75 FR 52798 - State-07, Cryptographic Clearance Records

    Science.gov (United States)

    2010-08-27

    ...: Unclassified. SYSTEM LOCATION: Department of State, 301 4th St., SW., Room 750 Washington, DC 20547. CATEGORIES... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF STATE State-07, Cryptographic Clearance Records Summary: Notice is hereby given that the Department of State proposes to...

  13. Renal posttransplant's vascular complications

    Directory of Open Access Journals (Sweden)

    Bašić Dragoslav

    2003-01-01

    Full Text Available INTRODUCTION Despite high graft and recipient survival figures worldwide today, a variety of technical complications can threaten the transplant in the postoperative period. Vascular complications are commonly related to technical problems in establishing vascular continuity or to damage that occurs during donor nephrectomy or preservation [13]. AIM The aim of the presenting study is to evaluate counts and rates of vascular complications after renal transplantation and to compare the outcome by donor type. MATERIAL AND METHODS A total of 463 kidneys (319 from living related donor LD and 144 from cadaveric donor - CD were transplanted during the period between June 1975 and December 1998 at the Urology & Nephrology Institute of Clinical Centre of Serbia in Belgrade. Average recipients' age was 33.7 years (15-54 in LD group and 39.8 (19-62 in CD group. Retrospectively, we analyzed medical records of all recipients. Statistical analysis is estimated using Hi-squared test and Fischer's test of exact probability. RESULTS Major vascular complications including vascular anastomosis thrombosis, internal iliac artery stenosis, internal iliac artery rupture obliterant vasculitis and external iliac vein rupture were analyzed. In 25 recipients (5.4% some of major vascular complications were detected. Among these cases, 22 of them were from CD group vs. three from LD group. Relative rate of these complications was higher in CD group vs. LD group (p<0.0001. Among these complications dominant one was vascular anastomosis thrombosis which occurred in 18 recipients (17 from CD vs. one from LD. Of these recipients 16 from CD lost the graft, while the rest of two (one from each group had lethal outcome. DISCUSSION Thrombosis of renal allograft vascular anastomosis site is the most severe complication following renal transplantation. In the literature, renal allograft thrombosis is reported with different incidence rates, from 0.5-4% [14, 15, 16]. Data from the

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

    Directory of Open Access Journals (Sweden)

    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.

  15. Lactate dehydrogenase as a biomarker for early renal damage in patients with sickle cell disease

    Directory of Open Access Journals (Sweden)

    Mohammad S Alzahri

    2015-01-01

    Full Text Available Among many complications of sickle cell disease, renal failure is the main contributor to early mortality. It is present in up to 21% of patients with sickle cell disease. Although screening for microalbuminuria and proteinuria is the current acceptable practice to detect and follow renal damage in patients with sickle cell disease, there is a crucial need for other, more sensitive biomarkers. This becomes especially true knowing that those biomarkers start to appear only after more than 60% of the kidney function is lost. The primary purpose of this study is to determine whether lactate dehydrogenase (LDH correlates with other, direct and indirect bio-markers of renal insufficiency in patients with sickle cell disease and, therefore, could be used as a biomarker for early renal damage in patients with sickle cell disease. Fifty-five patients with an established diagnosis of sickle cell disease were recruited to in the study. Blood samples were taken and 24-h urine collection samples were collected. Using Statcrunch, a data analysis tool available on the web, we studied the correlation between LDH and other biomarkers of kidney function as well as the distribution and relationship between the variables. Regression analysis showed a significant negative correlation between serum LDH and creatinine clearance, R (correlation coefficient = -0.44, P = 0.0008. This correlation was more significant at younger age. This study shows that in sickle cell patients LDH correlates with creatinine clearance and, therefore, LDH could serve as a biomarker to predict renal insufficiency in those patients.

  16. Early diagnosis of renal disease and renal failure.

    Science.gov (United States)

    Lees, George E

    2004-07-01

    The main goal of early diagnosis of renal disease and renal failure in dogs and cats is to enable timely application of therapeutic interventions that may slow or halt disease progression. Strategies for early diagnosis of renal disease use urine tests that detect proteinuria that is a manifestation of altered glomerular permselectivity or impaired urine-concentrating ability as well blood tests to evaluate plasma creatinine concentration. Animals with progressive renal disease should be carefully investigated and treated appropriately. Animals with mild, possibly nonprogressive, renal disease should be monitored adequately to detect any worsening trends,which should lead to further investigation and treatment even if the increments of change are small. PMID:15223206

  17. Relative hyperphosphaturia in diabetic chronic renal failure: a protective factor of hyperparathyroidism.

    Science.gov (United States)

    Aubia, J; Bosch, J; Lloveras, J; Chine, M; Hojman, L; Masramon, J

    1987-01-01

    Relative low serum levels of parathormone (PTH) and low incidence of secondary hyperparathyroidism have been reported in diabetic uremic patients. The pathogenesis of this reported resistance to uremic secondary hyperparathyroidism in diabetes remains controversial. We have measured the serum C-terminal parathormone (C-PTH) renal phosphorus threshold (TmPO4) and nephrogenous cyclic AMP (N-cCAMP), in 2-hour urine collection in 22 patients with diabetic nephropathy with moderate chronic renal failure and in 27 controls with similar creatinine clearance values (18.16 +/- 9.14 and and 19.1 +/- 8.47 ml/min). In spite of the lower levels of serum C-PTH (1.07 +/- 0.43 ng/ml) diabetic patients exhibited an increased phosphaturia (TmPO4: 1.97 +/- 0.9 mg/100 ml GFR) when compared with the control group (C-PTH: 2.01 +/- 1.17 mg/ml, and TmPO4: 2.5 +/- 0.7 ml GFR). When the C-PTH values were plotted against the logarithm of creatinine clearance values, both groups showed a significant linear relationship reflecting the progressive increase in PTH when GFR fell. This progressive parathyroid stimulus was also present in diabetic patients but in a lower intensity. We believe that increased phosphaturia in diabetics with moderate chronic renal failure may be a major factor in precluding the appearance of secondary hyperparathyroidism in these patients once they reach the dialysis and transplantation programs.

  18. Renal acidification defects in medullary sponge kidney

    DEFF Research Database (Denmark)

    Osther, P J; Hansen, A B; Røhl, H F

    1988-01-01

    Thirteen patients with medullary sponge kidney underwent a short ammonium chloride loading test to investigate their renal acidification capacity. All but 1 presented with a history of recurrent renal calculi and showed bilateral widespread renal medullary calcification on X-ray examination. Nine...... patients had some form of renal acidification defect; 8 had the distal type of renal tubular acidosis, 2 the complete and 6 the incomplete form. One patient had proximal renal tubular acidosis. These findings, which suggest that renal acidification defects play an important role in the pathogenesis...... of renal calculi in medullary sponge kidney, have considerable therapeutic implications....

  19. Citrato y litiasis renal

    Directory of Open Access Journals (Sweden)

    Elisa E. Del Valle

    2013-08-01

    Full Text Available El citrato es un potente inhibidor de la cristalización de sales de calcio. La hipocitraturia es una alteración bioquímica frecuente en la formación de cálculos de calcio en adultos y especialmente en niños. El pH ácido (sistémico, tubular e intracelular es el principal determinante de la excreción de citrato en la orina. Si bien la mayoría de los pacientes con litiasis renal presentan hipocitraturia idiopática, hay un número de causas para esta anormalidad que incluyen acidosis tubular renal distal, hipokalemia, dietas ricas en proteínas de origen animal y/o dietas bajas en álcalis y ciertas drogas, como la acetazolamida, topiramato, IECA y tiazidas. Las modificaciones dietéticas que benefician a estos pacientes incluyen: alta ingesta de líquidos y frutas, especialmente cítricos, restricción de sodio y proteínas, con consumo normal de calcio. El tratamiento con citrato de potasio es efectivo en pacientes con hipocitraturia primaria o secundaria y en aquellos desordenes en la acidificación, que provocan un pH urinario persistentemente ácido. Los efectos adversos son bajos y están referidos al tracto gastrointestinal. Si bien hay diferentes preparaciones de citrato (citrato de potasio, citrato de sodio, citrato de potasio-magnesio en nuestro país solo está disponible el citrato de potasio en polvo que es muy útil para corregir la hipocitraturia y el pH urinario bajo, y reducir marcadamente la recurrencia de la litiasis renal.

  20. Renal failure in Yemen.

    Science.gov (United States)

    Al-Rohani, M

    2004-01-01

    Renal failure remains a serious cause of mortality in Yemen. Our region has 1.25 million population and our hospital is the central hospital, which has a nephrology department and performs dialysis for the region. Between January 1998 and December 2002, we admitted 547 patients; including children, with acute renal failure (ARF) and chronic renal failure (CRF). CRF was observed in 400 patients, an incidence of 64 per million per year and a prevalence of 320 per million. ARF occurred in 147 persons with an incidence of 23.5 per million per year and a prevalence of 117.5 patients per million. Of all patients, 72% were adults (age range, 20-60 years) with a male preponderance. As a tropical country, malaria (27.9%), diarrhea (13.6%), and other infectious diseases were the main causes. Next most common were obstructive diseases causing CRF and ARF (26.8% and 12.9%, respectively), mainly urolithiasis, Schistosomiasis, and prostatic enlargement. However the cause of CRF in 57.5% of patients was unknown as most persons presented late with end-stage disease (64.7%), requiring immediate intervention. Other causes, such as hepatorenal syndrome, snake bite, diabetes mellitus, and hypertension, showed low occurrence rates. Patients presented to the hospital mostly in severe uremia and without a clear history of prior medications. The major findings were vomiting, acidosis, and hypertension with serum creatinine values ranging between 2.8-45 mg/dL (mean value, 13.4 mg/dL). Anemia was observed in 80.4% of CRF versus 62.6% of ARF patients. Hypertension prevalence was 65.5% among CRF patients, of whom 25% were in hypertensive crisis, whereas among ARF the prevalence was only 26.5%. PMID:15350475