Renal Function Recovery with Total Artificial Heart Support.

Science.gov (United States)

Quader, Mohammed A; Goodreau, Adam M; Shah, Keyur B; Katlaps, Gundars; Cooke, Richard; Smallfield, Melissa C; Tchoukina, Inna F; Wolfe, Luke G; Kasirajan, Vigneshwar

2016-01-01

Heart failure patients requiring total artificial heart (TAH) support often have concomitant renal insufficiency (RI). We sought to quantify renal function recovery in patients supported with TAH at our institution. Renal function data at 30, 90, and 180 days after TAH implantation were analyzed for patients with RI, defined as hemodialysis supported or an estimated glomerular filtration rate (eGFR) less than 60 ml/min/1.73 m. Between January 2008 and December 2013, 20 of the 46 (43.5%) TAH recipients (age 51 ± 9 years, 85% men) had RI, mean preoperative eGFR of 48 ± 7 ml/min/1.73 m. Renal function recovery was noted at each follow-up interval: increment in eGFR (ml/min/1.73 m) at 30, 90, and 180 days was 21 ± 35 (p = 0.1), 16.5 ± 18 (p = 0.05), and 10 ± 9 (p = 0.1), respectively. Six patients (30%) required preoperative dialysis. Of these, four recovered renal function, one remained on dialysis, and one died. Six patients (30%) required new-onset dialysis. Of these, three recovered renal function and three died. Overall, 75% (15 of 20) of patients' renal function improved with TAH support. Total artificial heart support improved renal function in 75% of patients with pre-existing significant RI, including those who required preoperative dialysis.

Renal Function Outcomes for Multifocal Renal Neoplasms Managed by Radiofrequency Ablation

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

2013-10-15

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

Estimating renal function in children: a new GFR-model based on serum cystatin C and body cell mass.

Science.gov (United States)

Andersen, Trine Borup

2012-07-01

This PhD thesis is based on four individual studies including 131 children aged 2-14 years with nephro-urologic disorders. The majority (72%) of children had a normal renal function (GFR > 82 ml/min/1.73 square metres), and only 8% had a renal function thesis´ main aims were: 1) to develop a more accurate GFR model based on a novel theory of body cell mass (BCM) and cystatin C (CysC); 2) to investigate the diagnostic performance in comparison to other models as well as serum CysC and creatinine; 3) to validate the new models precision and validity. The model´s diagnostic performance was investigated in study I as the ability to detect changes in renal function (total day-to-day variation), and in study IV as the ability to discriminate between normal and reduced function. The model´s precision and validity were indirectly evaluated in study II and III, and in study I accuracy was estimated by comparison to reference GFR. Several prediction models based on CysC or a combination of CysC and serum creatinine have been developed for predicting GFR in children. Despite these efforts to improve GFR estimates, no alternative to exogenous methods has been found and the Schwartz´s formula based on height, creatinine and an empirically derived constant is still recommended for GFR estimation in children. However, the inclusion of BCM as a possible variable in a CysC-based prediction model has not yet been explored. As CysC is produced at a constant rate from all nucleated cells we hypothesize that including BCM in a new prediction model will increase accuracy of the GFR estimate. Study I aimed at deriving the new GFR-prediction model based on the novel theory of CysC and BCM and comparing the performance to previously published models. The BCM-model took the form GFR (mL/min) = 10.2 × (BCM/CysC)E 0.40 × (height × body surface area/Crea)E 0.65. The model predicted 99% within ± 30% of reference GFR, and 67% within ±10%. This was higher than any other model. The

Endogenous markers for estimation of renal function in peritoneal dialysis patients

DEFF Research Database (Denmark)

Kjaergaard, Krista Dybtved; Jensen, Jens Dam; Rehling, Michael

2012-01-01

OBJECTIVE: This method comparison study, conducted at the peritoneal dialysis (PD) outpatient clinic of the Department of Renal Medicine, Aarhus University Hospital, Denmark, set out to evaluate the accuracy and reproducibility of methods for estimating glomerular filtration rate (GFR) based...

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

Estimating glomerular filtration rate: Cockcroft-Gault and Modification of Diet in Renal Disease formulas compared to renal inulin clearance.

NARCIS (Netherlands)

Botev, R.; Mallie, J.P.; Couchoud, C.; Schuck, O.; Fauvel, J.P.; Wetzels, J.F.M.; Lee, N.; Santo, N.G. De; Cirillo, M.

2009-01-01

BACKGROUND AND OBJECTIVES: Evaluation of renal function by estimation of the glomerular filtration rate (GFR) is very important for the diagnosis and treatment of patients with chronic kidney disease (CKD). The Cockcroft-Gault (CG) and Modification of Diet in Renal Disease (MDRD) formulas are the

In vivo estimation of renal volume using a rotating gamma camera for sup(99m)Tc-dimercaptosuccinic acid renal imaging

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Kawamura, J; Itoh, H; Yoshida, O; Fujita, T; Torizuka, K

1984-03-01

The in vivo renal volume was determined using SPECT for sup(99m)Tc-DMSA renal imaging. The total renal volume was derived by summing the DMSA distribution volumes of the transaxial slices in the whole kidney. In 20 healthy subjects the renal volume in the right kidney was 220 ml for men and 195.2 ml for women, while that in the left kidney was 213 ml for men and 193.7 ml for women. Differences in those values were not statistically significant. A good correlation was found between renal volumes in both kidneys and body surface area. In 106 kidneys including solitary and pathological kidneys, individual renal volume correlated well with individual DMSA renal uptake rate which demonstrates cortical functioning mass, depending on the cortical blood flow. Thus, SPECT enables an accurate noninvasive means of estimating in vivo functioning renal volume.

Renal function and long-term decline in cognitive function: the Baltimore Longitudinal Study of Aging.

Science.gov (United States)

Seliger, Stephen L; Wendell, Carrington R; Waldstein, Shari R; Ferrucci, Luigi; Zonderman, Alan B

2015-01-01

Renal disease has been associated with greater risk of dementia and greater cognitive impairment. However, the relationship of lower renal function with long-term decline in specific domains of cognitive function remains unclear among community-dwelling, non-demented individuals. Stroke- and dementia-free participants (n = 2,116) were enrolled in the Baltimore Longitudinal Study of Aging, a community-based, prospective, longitudinal study. Renal function was estimated by the inverse of serum creatinine adjusted for age, sex and race and (in sensitivity analyses) estimated glomerular filtration rate (eGFR) using the MDRD formula. Outcome measures were changes in scores on 6 cognitive tests encompassing a range of cognitive functions, measured at 2-year intervals. Mixed-effects regression models examined the longitudinal relations of renal function with cognitive functions after adjusting for demographics, comorbidity and other potential confounders. Mean age at initial testing was 53.9 years (SD 17.1), and 94 participants (4.4%) had an eGFR age, longitudinal increases in creatinine concentrations were associated with more rapid decline in performance on several cognitive measures, including the learning slope of the California Verbal Learning Test, a test of verbal learning (p renal function independently associated with greater long-term declines in visual memory and verbal memory and learning. © 2015 National Institutes of Health (NIH). Published by S. Karger AG, Basel.

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

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

2010-07-01

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

Radionuclide estimation of kidney function in patients with acute renal failure

International Nuclear Information System (INIS)

Ilic, S.; Bogicevic, M.; Stefanovic, V.

1989-01-01

In order to evaluate kidney function radionuclide studies were made in 51 patients with different phases of acute renal failure within the period of six months from the beginning of underlying disease. Low 99m -Tc-DTPA clearance values meaning a marked reduction of glomerular filtration rate in oligoanuric phase, with an improvement but not normalization during diuretic and recovery phase. A decrease of the effective renal plasma flow was also found in 131 I-hippurate studies. In the oligoanuric phase glomerular filtration rate was more severely impaired than renal plasma flow, while in the recovery phase this difference disappeared. In the oligoanuric phase of ARF 99m Tc-DTPA dynamic curves were aplated and those of 131 I-hippurate showed accumulation type, in the diuretic phase hypofunction type with both radionuclides, in the recovery phase a minority of them were completely normalized. It is suggested that radionuclide methods should be used to evaluate and follow up kidney function in patients with different phases of ARF. (orig.) [de

MR evaluation of renal function. A preliminary study

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Beomonte Zobel, B; Giammarile, F; Matarese, A; Gallucci, M; Mascicchi, C; Passariello, R; Di Renzi, P; Splendiani, G; Casciani, C U

1988-01-01

The amount of functioning renal parenchyma can be estimated by MRI by considering the ratio between the mean intensities of cortical and medullar zones of the kidney. Fifty-six patients and 5 healthy volunteers were studied by MRI in our department. Scanning was performed with a superconductive magnet system operating at 0.5 Tesla. Pulse sequence was Spin-Echo with TR 300/TE 30 ms. The cortimedullary ratio (CMR) and differentiation (CMD) were standardized and related with creatine blood levels. CMR data ranged from 1.05 to 3.00, while CMD data ranged from 0.04 to 0.50. High values (good cortico-medullary contrast) were observed in subjects with normal renal function. Patients with renal diseases had low CMR and CMD, proportionally to the degree of renal failure, as proved by laboratory findings. Our preliminary study seems to demonstrate that MRI is an useful technique in the follow-up of patients with chronic renal disease. 19 refs.

Quantitative estimation of renal function with dynamic contrast-enhanced MRI using a modified two-compartment model.

Directory of Open Access Journals (Sweden)

Bin Chen

Full Text Available To establish a simple two-compartment model for glomerular filtration rate (GFR and renal plasma flow (RPF estimations by dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI.A total of eight New Zealand white rabbits were included in DCE-MRI. The two-compartment model was modified with the impulse residue function in this study. First, the reliability of GFR measurement of the proposed model was compared with other published models in Monte Carlo simulation at different noise levels. Then, functional parameters were estimated in six healthy rabbits to test the feasibility of the new model. Moreover, in order to investigate its validity of GFR estimation, two rabbits underwent acute ischemia surgical procedure in unilateral kidney before DCE-MRI, and pixel-wise measurements were implemented to detect the cortical GFR alterations between normal and abnormal kidneys.The lowest variability of GFR and RPF measurements were found in the proposed model in the comparison. Mean GFR was 3.03±1.1 ml/min and mean RPF was 2.64±0.5 ml/g/min in normal animals, which were in good agreement with the published values. Moreover, large GFR decline was found in dysfunction kidneys comparing to the contralateral control group.Results in our study demonstrate that measurement of renal kinetic parameters based on the proposed model is feasible and it has the ability to discriminate GFR changes in healthy and diseased kidneys.

Renal function after prolonged hypotensive anesthesia and surgery in dogs with reduced renal mass.

Science.gov (United States)

Stone, E A; Rawlings, C A; Finco, D R; Crowell, W A

1981-10-01

The effect of prolonged hypotensive anesthesia and surgery on renal function was studied in 8 dogs with decreased renal mass. Renal mass was reduced by unilateral nephrectomy and ligation of 4 of the 6 terminal renal artery branches of the opposite kidney. One week after reduction in renal mass, the dogs were azotemic with a serum urea nitrogen (SUN) value of 65.8 +/- 11.5 mg/dl. Glomerular filtration rate, as estimated by 14C-inulin clearance, was 0.66 +/- 0.19 ml/kg of body weight/hour. A mean arterial pressure of less than 75 mm of Hg was maintained for 4 hours in dogs given 2.3 +/- 0.7% halothane. An exploratory laparotomy lasting 1 hour was performed. The day after the hypotensive episode, 3 dogs began vomiting, became dehydrated, and had SUN values greater than 100 mg/dl. The SUN values returned to base-line values after the dogs were rehydrated. Eight days after the hypotensive episode, 14C-inulin clearance decreased 15.2 +/- 8.2% (P less than 0.005) compared with base-line clearance values. Light microscopic and electron microscopic observations of the kidneys did not demonstrate acute renal failure. Prolonged hypotensive anesthesia can cause a decrease in renal function, and may cause prerenal uremia and/or acute renal failure.

Effect of nitrendipine on renal function and on hormonal parameters after intravascular iopromide

DEFF Research Database (Denmark)

Madsen, J K; Jensen, J W; Sandermann, J

1998-01-01

PURPOSE: To evaluate the effect of the low-molecular nonionic radiographic contrast agent iopromide (Ultravist) on renal function, vasoactive peptides (angiotensin II, aldosterone, arginine vasopressin, and atrial natriuretic factor (ANF)), and blood pressure, and to evaluate the influence....... Renal tubular function was estimated from the clearance of lithium. Hormones were measured by radioimmunoassays. RESULTS: Arteriography with iopromide did not change renal function. No differences between the nitrendipine and placebo groups were found in renal hemodynamics, tubular sodium handling...

Different methods of hilar clamping during partial nephrectomy: Impact on renal function.

Science.gov (United States)

Lee, Jeong Woo; Kim, Hwanik; Choo, Minsoo; Park, Yong Hyun; Ku, Ja Hyeon; Kim, Hyeon Hoe; Kwak, Cheol

2014-03-01

To evaluate the impact of different hilar clamping methods on changes in renal function after partial nephrectomy. We analyzed the clinical data of 369 patients who underwent partial nephrectomy for a single renal tumor of size ≤4.0 cm and a normal contralateral kidney. Patients were separated into three groups depending on hilar clamping method: non-clamping, cold ischemia and warm ischemia. Estimated glomerular filtration rate was examined at preoperative, nadir and 1 year postoperatively. Percent change in estimated glomerular filtration rate was used as the parameter to assess the renal functional outcome. Percent change in nadir estimated glomerular filtration rate in the non-clamping group was significantly less compared with the cold ischemia and warm ischemia groups (P hilar clamping (both warm ischemia and cold ischemia) were significantly associated with percent change in nadir estimated glomerular filtration rate, but not in 1-year estimated glomerular filtration rate. Non-clamping partial nephrectomy results in a lower percent change in nadir estimated glomerular filtration rate, whereas it carries an estimated glomerular filtration rate change at 1 year that is similar to partial nephrectomy with cold ischemia and warm ischemia. Cold ischemia and warm ischemia provide a similar effect on renal function. Therefore, when hilar clamping is required, minimization of ischemia time is necessary. © 2013 The Japanese Urological Association.

Renal functional reserve and tubular function in patents with type 2 diabetes mellitus

Directory of Open Access Journals (Sweden)

Dilyara Makhmutrievna Khakimova

2011-06-01

Full Text Available Aim. To study renal functional reserve and partial functions in patents with type 2 diabetes mellitus in the absence of renal lesionsMaterials and methods. We examined 42 patients (17 men and 24 women aged 38-69 (mean 49.8?8.3 years with DM2 4.6?2.6 yr in duration.Control group comprised 32 practically healthy subjects. Intrarenal hemodynamics was estimated from RFR values. Ethanolamine, uric acid, Ca,and P levels were measured in sera and 24-hr urine; daily excretion of ammonia and aminonitrogen in the urine was determined. Results. The patients were divided into 2 groups based on the results of RFR measurement. FRF remained unaltered in 21 patients (mean 60.7?27.6%and decreased in the absence of filtration reserve in 20 (-25.8?23.4%. Correlation analysis revealed the relationship of lipid metabolism and abdominalobesity with the renal tubular function and intraglomerular hemodynamics. Conclusion. Examination of DM2 patients without clinical and laboratory signs of renal lesions revealed compromised function of all nephron compartments,viz. intraglomerular hypertension, impaired stability of renal cell membranes, and tubular dysfunction. The latter is related to hemodynamic disturbances.

A gamma camera method for quantitation of split renal function in children followed for vesicoureteric reflux

International Nuclear Information System (INIS)

Tamminen, T.E.; Riihimaeki, E.J.; Taehti, E.E.; Helsinki Univ. Central Hospital

1978-01-01

A method for quantitative estimation of split renal function using a computerized gamma camera system is described. 42 children and adolescents with existing or preexisting vesicouretric reflux and recurrent urinary tract infection were investigated. Total renal clearance of DTPA was calculated with a disapperarance curve derived from the largest extrarenal area in the field of view of a gamma camera with diverging collimator. Split renal function was estimated with the slopes of second phase renograms. The plasma disaapearance clearance of DTPA, calculated using one compartement model with two late blood samples, gave similar resusults with the clearance estimated from the body disappearance curves. The proportional planimetric renal parenchymal areas had good correlation with the split clearance estimated from renogram slopes. The method offers data on renal function and urinary tract dynamics which is very valuable in the follow-up of children with recurrent urinary tract infection and vesicoureteric reflux. (orig.) [de

Radionuclide renal dynamic and function study

International Nuclear Information System (INIS)

Guan Liang

1991-01-01

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

Influences of renal stone surgeries on renal function; Evaluation of renal function with sup 99m Tc-DMSA renal scintigraphy

Energy Technology Data Exchange (ETDEWEB)

Katayama, Yasushi (Niigata Univ. (Japan). School of Medicine)

1991-10-01

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

Renal function changes associated with aging and ionizing radiation

International Nuclear Information System (INIS)

Miller, C.W.; Norrdin, R.W.; Sawyer, S.S.; Nealeigh, R.C.

1978-01-01

Renal function testing of irradiated and unirradiated beagles at CRHL has been carried out for the past 7 years using a simultaneous estimation of sodium sulfanilate and sodium iodohippurate 131 I clearance. Evidence has been cited that the beagle kidney is markedly sensitive to whole-body ionizing radiation delivered in the perinatal period. The objectives of this continuing study are to determine the nature of the progression of chronic renal disease, its possible association to hypertension, the impact of unilateral nephrectomy upon an already compromised renal parenchyma, and the age-related changes in renal function. Thus far, data seem to indicate the following conclusions: sulfanilate clearance appears to be a sensitive indicator of impending renal failure, exhibiting earlier and more obvious indicators than BUN (blood urea nitrogen) levels; hypertension does not appear to be a factor in radiation-induced renal failure in the adult dogs studied here, since the average arterial blood pressure was as high in normal control dogs as in irradiated dogs suffering from renal failure; unilateral nephrectomy affected unirradiated dogs less than irradiated animals with mild renal insufficiency. The BUN levels returned to prenephrectomy levels in 8 weeks in the unirradiated group, but required up to 1 year in the dogs with renal insufficiency; and an age related decrease inrenal function was observed in a group of unirradiated dogs studied from 0 to 2 through 13 years of age

Cystatin C a marker for renal function after exercise.

Science.gov (United States)

Mingels, A; Jacobs, L; Kleijnen, V; Wodzig, W; Dieijen-Visser, M van

2009-09-01

Renal impairment is common during and after severe exercise. In clinical practice, renal function is evaluated using serum creatinine, urine parameters, and equations to estimate the Glomular Filtration Rate (GFR). However, creatinine levels may be biased by skeletal muscle damage and the GFR equations, requiring age, gender and body weight, are shown to be inadequate in normals. In the present study, we show that serum cystatin C and creatinine concentrations were elevated after marathon running in 26% and 46% of the 70 recreational male runners, respectively, possibly because of reduction in renal blood flow. The mean cystatin C increase was twice as low as compared to creatinine (21% and 41%, respectively), suggesting that cystatin C is indeed less biased by muscle damage. Future research has to reveal whether training diminishes the elevation in renal markers. Overall, cystatin C seems a more reliable method to establish renal function during and after extensive exercise. Georg Thieme Verlag KG Stuttgart.

Comparison between doppler ultrasonography and renal scintigraphy in assessment of post-transplant renal function

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Yoon, Yeo Chang; Shin, Byung Seok; Ohm, Joon Young; Kim, Seong Min; Ahn, Moon Sang; Yang, Shin Seok [Chungnam National University Hospital, Daejeon (Korea, Republic of); Park, Mi Hyun [Dept. of Radiology, Dankook University Hospital, Cheonan (Korea, Republic of)

2016-05-15

To compare the usefulness of Doppler ultrasonography and renal scintigraphy in the assessment of short- and long-term function of transplanted kidneys. We retrospectively reviewed the cases of 79 patients who underwent Doppler ultrasonography and technetium-99m diethylene triamine pentaacetic acid renal scintigraphy on the same day, within 4 days of renal transplantation. Image parameters were evaluated for statistical differences. There was a strong positive correlation between the glomerular filtration rate (GFR) as measured by renal scintigraphy and the estimated GFR (eGFR) based on serum creatinine levels (correlation coefficient = 0.71). Scan grade according to the time-activity curve, resistive index, and end diastolic velocity showed moderate correlations with the eGFR (correlation coefficients = -0.557, -0.329, and 0.370, respectively) in the early post-transplantation period. The mean survival time was longer in patients with lower resistive indices (≤ 0.68, 54.9 months vs. > 0.68, 29.5 months) and lower pulsatility indices (≤ 1.32, 53.8 months vs. > 1.32, 28.7 months); however, there were no statistically significant differences in the long-term follow-up period (p = 0.121 for resistive index and p = 0.074 for pulsatility index). Renal scintigraphy is a more sensitive method than Doppler ultrasonography for assessing transplanted kidney function in the early post-transplantation period. Doppler ultrasonography might reflect the long-term survival time. However, it is difficult to predict long-term renal function using either method.

Comparison between doppler ultrasonography and renal scintigraphy in assessment of post-transplant renal function

International Nuclear Information System (INIS)

Yoon, Yeo Chang; Shin, Byung Seok; Ohm, Joon Young; Kim, Seong Min; Ahn, Moon Sang; Yang, Shin Seok; Park, Mi Hyun

2016-01-01

To compare the usefulness of Doppler ultrasonography and renal scintigraphy in the assessment of short- and long-term function of transplanted kidneys. We retrospectively reviewed the cases of 79 patients who underwent Doppler ultrasonography and technetium-99m diethylene triamine pentaacetic acid renal scintigraphy on the same day, within 4 days of renal transplantation. Image parameters were evaluated for statistical differences. There was a strong positive correlation between the glomerular filtration rate (GFR) as measured by renal scintigraphy and the estimated GFR (eGFR) based on serum creatinine levels (correlation coefficient = 0.71). Scan grade according to the time-activity curve, resistive index, and end diastolic velocity showed moderate correlations with the eGFR (correlation coefficients = -0.557, -0.329, and 0.370, respectively) in the early post-transplantation period. The mean survival time was longer in patients with lower resistive indices (≤ 0.68, 54.9 months vs. > 0.68, 29.5 months) and lower pulsatility indices (≤ 1.32, 53.8 months vs. > 1.32, 28.7 months); however, there were no statistically significant differences in the long-term follow-up period (p = 0.121 for resistive index and p = 0.074 for pulsatility index). Renal scintigraphy is a more sensitive method than Doppler ultrasonography for assessing transplanted kidney function in the early post-transplantation period. Doppler ultrasonography might reflect the long-term survival time. However, it is difficult to predict long-term renal function using either method

Glomerular Filtration Rate Estimation in Renal and Non-Renal Solid Organ Transplantation

DEFF Research Database (Denmark)

Hornum, Mads; Feldt-Rasmussen, Bo

2017-01-01

Following transplantation (TX) of both renal and non-renal organs, a large proportion of patients have renal dysfunction. There are multiple causes for this. Chronic nephrotoxicity and high doses of calcineurin inhibitors are important factors. Preoperative and perioperative factors like hyperten......Following transplantation (TX) of both renal and non-renal organs, a large proportion of patients have renal dysfunction. There are multiple causes for this. Chronic nephrotoxicity and high doses of calcineurin inhibitors are important factors. Preoperative and perioperative factors like...... hypertension, hypotension, drugs and infections may play a causative role as well. Organ-specific causes include hepatorenal syndrome, cirrhosis, low cardiac function, low respiratory function and diabetes developed both before and after TX. It is important to be able to perform precise and valid measurements...... rate methods for use in renal and non-renal TX....

Re-estimation of renal function with 99mTc-DTPA by the Gates' method

International Nuclear Information System (INIS)

Itoh, Kazuo; Arakawa, Masanori

1987-01-01

We analyzed a regression equation between percent total renal uptake (%TRU) of 99m Tc-DTPA and creatinine clearance (Ccr) by the Gates' method in 82 patients. 1) The following regression equations between measured renal depth on CT scan and (weight in kg)/(height in cm) in Japanese were obtained; Right in both kidneys = 13.6361 · (W/H) 0.6996 (n = 217, r = 0.86691, p 0.7554 (n = 224, r = 0.8822, p 0.8099 (n = 27, r = 0.9515, p 0.6997 (n = 21, r = 0.9213, p 2 ) = 13.15 · %TRU 0.787 (n = 86, r = 0.820, p 0.753 (n = 40, r = 0.754). The Gates' method is very convenient for an immediate estimation of glomerular filtration rate (GFR) after renal scintigraphy using 99m Tc-DTPA. However, the correlation coefficient was not high as compared to the Gates' results. The equation which was reported by Gates' is not necessarily adaptable in routine study. Each facility which uses the Gates' method for estimating GFR should obtain the corrected regression equation between %TRU and Ccr. (author)

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 healt...... transplant recipients treated with a low maintenance dose of CsA had a well-preserved renal functional reserve, and dietary supplementation with fish oil in these patients did not improve renal function.......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...... volunteers (N = 9) and two groups of stable long-term kidney-transplanted patients treated with maintenance low-dose CsA (3.0 +/- 0.6 mg/kg; N = 9) or without CsA (N = 9). After an overnight fast, the subjects were water loaded, and clearance studies were performed, postponing morning medication. GFR...

Relationship between renal cortex and parenchyma thickness and renal function: study with CT measurement

International Nuclear Information System (INIS)

Xu Yufeng; Tang Guangjian; Jiang Xuexiang

2006-01-01

Objective: To study the relationship between renal morphology and renal function, and to assess the value of CT as a criterion to grade renal function. Methods: Enhancement CT were performed in 89 patients with no local renal disease whose split renal glomerular filtration rates (GFR) were measured by renal dynamic imaging with 99 Tc m -DTPA. The 178 kidneys were divided into normal renal function, mild and severe renal impairment groups according to renal function. Differences between three groups respect to the mean thickness of renal cortex and parenchyma were assessed by ANOVA. Using Pearson's correlation test, the correlation between the renal cortex, parenchyma thicknesses and renal GFR were examined. The value of CT in predicting renal function was assessed by using ROC analysis. Results: The renal cortex thicknesses of normal renal function, mild and severe renal impairment groups were (5.9±1.1), (4.6± 1.1), and (3.3±1.0) mm respectively, and the renal parenchyma thicknesses were (26.3±4.2), (21.3±4.6), (16.2±4.6) mm. There were significant differences of renal cortex, parenchyma thicknesses between 3 groups (cortex F=54.78, P<0.01; parenehyma F=43.90, P<0.01). The thicknesses of renal cortex (r=0.752, P<0.01), parenchyma (r=0.738, P<0.01) had positive linear correlation with renal function. ROC analysis of the renal cortex thicknesses measured by CT in predicting mild and severe renal impairment showed that the Az was 0.860 and 0.905 respectively, whereas that of parenchyma was 0.868 and 0.884. Conclusion: The thicknesses of renal cortex, parenchyma measured by CT can reflect renal function. CT was a supplementary method to assess renal function. (authors)

Preoperative renal function and surgical outcomes in patients with acute type A aortic dissection†.

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Imasaka, Ken-ichi; Tayama, Eiki; Tomita, Yukihiro

2015-04-01

There are few data concerning the impact of preoperative renal function, assessed using estimated glomerular filtration rate, on surgical outcomes following acute type A aortic dissection. We investigated the accuracy of estimated glomerular filtration rate (in ml/min/1.73 m(2)) in predicting in-hospital mortality and postoperative renal replacement therapy in such cases. We reviewed 114 consecutive patients with non-dialysis-dependent renal dysfunction who underwent thoracic aortic surgery for acute type A aortic dissection between 1997 and 2012. Preoperative renal function was categorized as normal (estimated glomerular filtration rate >90; n = 15) or as mild (60-89; n = 39), moderate I (45-59; n = 39), moderate II (30-44; n = 14) or severe (15-29; n = 7) renal dysfunction. In-hospital mortality was 14.9%. Eighteen (15.8%) of 114 patients required renal replacement therapy. A more severe stage stratified by preoperative estimated glomerular filtration rate levels could effectively predict postoperative renal replacement therapy (area under the receiver operating characteristic curve 0.786). The best cut-off value of estimated glomerular filtration rate for predicting postoperative renal replacement therapy was 60 (sensitivity 95%, specificity 59%). On multiple regression analysis, the independent preoperative and intraoperative risk factors for postoperative renal replacement therapy were estimated glomerular filtration rate (P replacement (P replacement therapy (OR, 5.47; P regression analysis. Preoperative estimated glomerular filtration rate can effectively predict the need for renal replacement therapy after surgery for acute type A aortic dissection. However, it is not an effective diagnostic tool to predict in-hospital mortality. The complexity of the characteristics of patients who undergo surgical procedures may make prediction of surgical outcomes difficult. Risk models to predict hospital mortality and morbidities are needed to assist clinicians in

Drug Dosing and Estimated Renal Function-Any Step Forward from Effersoe?

DEFF Research Database (Denmark)

Hornum, Mads; Feldt-Rasmussen, Bo

2017-01-01

Drug dosing in accordance with the renal function is a long-standing challenge to clinicians. For many years it has been evident that in many clinical situations there is no easy way to correctly dose any drug that is mainly cleared by the kidneys. Despite the development of many formulas...

Well Preserved Renal Function in Children With Untreated Chronic Liver Disease.

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Berg, Ulla B; Németh, Antal

2018-04-01

On the basis of studies with hepatorenal syndrome, it is widely regarded that renal function is impacted in chronic liver disease (CLD). Therefore, we investigated renal function in children with CLD. In a retrospective study of 277 children with CLD, renal function was investigated as glomerular filtration rate (GFR) and effective renal plasma flow (ERPF), measured as clearance of inulin and para-amino hippuric acid or clearance of iohexol. The data were analyzed with regard to different subgroups of liver disease and to the grade of damage. Hyperfiltration (>+2 SD of controls) was found in the subgroups of progressive familial intrahepatic cholestasis (44%), glycogenosis (75%), and acute fulminant liver failure (60%). Patients with biliary atresia, most other patients with metabolic disease and intrahepatic cholestasis, and those with vascular anomalies and cryptogenic cirrhosis had normal renal function. Decreased renal function was found in patients with Alagille's syndrome (64% < -2 SD). Increased GFR and ERPF was found in patients with elevated transaminases, low prothrombin level, high bile acid concentration, and high aspartate-aminotransferase-to-platelet ratio. Most children with CLD had surprisingly well preserved renal function and certain groups had even hyperfiltration. The finding that children with decompensated liver disease and ongoing liver failure had stable kidney function suggests that no prognostic markers of threatening hepatorenal syndrome were at hand. Moreover, estimation of GFR based on serum creatinine fails to reveal hyperfiltration.

[Kidney function and renal cancer surgery].

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Izzedine, Hassan; Méjean, Arnaud; Escudier, Bernard

2014-02-01

Although radical nephrectomy is still practiced in many patients with large renal tumors, oncology and nephrology arguments for kidney-sparing approach for small renal masses has taken over this first. Indeed, partial nephrectomy provides equivalent oncologic results while preserving renal function and thereby limit morbidity and cardiovascular mortality related to chronic kidney disease. In addition, patients who develop kidney cancer often have medical comorbidities that may affect renal function, such as diabetes and hypertension. Histological examination of renal tissue adjacent to the tumor showed significant pathological changes in the majority of patients. For elderly patients or patients with comorbidities, active surveillance allows kidney-sparing approach with extremely low rates of progression and metastasis of cancer disease. Despite these significant advances in understanding for the treatment of small renal masses, partial nephrectomy remains underused. Better management must take into account the preservation of renal function in order to increase overall survival. A strategy for the systematic evaluation of renal function in patients with CR, with multidisciplinary staff (nephrologist urologist and oncologist), is therefore highly desirable.

Effects of Treating Primary Aldosteronism on Renal Function.

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Kramers, Bart J; Kramers, Cornelis; Lenders, Jacques W M; Deinum, Jaap

2017-03-01

Longstanding primary aldosteronism (PA) has deleterious effects on renal function, often masked until treatment (adrenalectomy or spironolactone) is initiated. It has been suggested that PA causes relative glomerular hyperfiltration, explaining the decline in estimated glomerular filtration rate (eGFR) after treatment. In this retrospective study, the authors retrieved the clinical characteristics and eGFR of 134 PA patients before and 6 months after treatment. Using multiple regression analysis, the predictors for eGFR decline and the predictors of ultimately attained renal function in 113 patients was assessed. eGFR declined by 15.3±14.2 (range 19-63) mL/min, independent predictors were pretreatment plasma aldosterone, eGFR, plasma renin, and plasma potassium. Independent predictors of ultimately attained eGFR after treatment were pretreatment plasma aldosterone, age, eGFR, and plasma potassium. Our findings lend support to the hypothesis that higher aldosterone levels cause relative glomerular hyperfiltration. The severity of pretreatment aldosterone excess is the most important risk factor for renal function decline. ©2016 Wiley Periodicals, Inc.

Renal volume assessed by magnetic resonance imaging volumetry correlates with renal function in living kidney donors pre- and postdonation: a retrospective cohort study.

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Lange, Daniel; Helck, Andreas; Rominger, Axel; Crispin, Alexander; Meiser, Bruno; Werner, Jens; Fischereder, Michael; Stangl, Manfred; Habicht, Antje

2018-07-01

Renal function of potential living kidney donors is routinely assessed with scintigraphy. Kidney anatomy is evaluated by imaging techniques such as magnetic resonance imaging (MRI). We evaluated if a MRI-based renal volumetry is a good predictor of kidney function pre- and postdonation. We retrospectively analyzed the renal volume (RV) in a MRI of 100 living kidney donors. RV was correlated with the tubular excretion rate (TER) of MAG3-scintigraphy, a measured creatinine clearance (CrCl), and the estimated glomerular filtration rate (eGFR) by Cockcroft-Gault (CG), CKD-EPI, and modification of diet in renal disease (MDRD) formula pre- and postdonation during a follow-up of 3 years. RV correlated significantly with the TER (total: r = 0.6735, P volumetry might be an alternative technique for the evaluation of split renal function and prediction of renal function postdonation in living kidney donors. © 2018 Steunstichting ESOT.

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

Institute of Scientific and Technical Information of China (English)

Yi-Jing; Sheen; Wayne; HH; Sheu

2014-01-01

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

Nephrotic range proteinuria as a strong risk factor for rapid renal function decline during pre-dialysis phase in type 2 diabetic patients with severely impaired renal function.

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Kitai, Yuichiro; Doi, Yohei; Osaki, Keisuke; Sugioka, Sayaka; Koshikawa, Masao; Sugawara, Akira

2015-12-01

Proteinuria is an established risk factor for progression of renal disease, including diabetic nephropathy. The predictive power of proteinuria, especially nephrotic range proteinuria, for progressive renal deterioration has been well demonstrated in diabetic patients with normal to relatively preserved renal function. However, little is known about the relationship between severity of proteinuria and renal outcome in pre-dialysis diabetic patients with severely impaired renal function. 125 incident dialysis patients with type 2 diabetes were identified. This study was aimed at retrospectively evaluating the impact of nephrotic range proteinuria (urinary protein-creatinine ratio above 3.5 g/gCr) on renal function decline during the 3 months just prior to dialysis initiation. In total, 103 patients (82.4 %) had nephrotic range proteinuria. The median rate of decline in estimated glomerular filtration rate (eGFR) in this study population was 0.98 (interquartile range 0.51-1.46) ml/min/1.73 m(2) per month. Compared to patients without nephrotic range proteinuria, patients with nephrotic range proteinuria showed significantly faster renal function decline (0.46 [0.24-1.25] versus 1.07 [0.64-1.54] ml/min/1.73 m(2) per month; p = 0.007). After adjusting for gender, age, systolic blood pressure, serum albumin, calcium-phosphorus product, hemoglobin A1c, and use of an angiotensin-converting enzyme inhibitor or an angiotensin II receptor blocker, patients with nephrotic range proteinuria showed a 3.89-fold (95 % CI 1.08-14.5) increased risk for rapid renal function decline defined as a decline in eGFR ≥0.5 ml/min/1.73 m(2) per month. Nephrotic range proteinuria is the predominant renal risk factor in type 2 diabetic patients with severely impaired renal function receiving pre-dialysis care.

Novel prediction model of renal function after nephrectomy from automated renal volumetry with preoperative multidetector computed tomography (MDCT).

Science.gov (United States)

Isotani, Shuji; Shimoyama, Hirofumi; Yokota, Isao; Noma, Yasuhiro; Kitamura, Kousuke; China, Toshiyuki; Saito, Keisuke; Hisasue, Shin-ichi; Ide, Hisamitsu; Muto, Satoru; Yamaguchi, Raizo; Ukimura, Osamu; Gill, Inderbir S; Horie, Shigeo

2015-10-01

The predictive model of postoperative renal function may impact on planning nephrectomy. To develop the novel predictive model using combination of clinical indices with computer volumetry to measure the preserved renal cortex volume (RCV) using multidetector computed tomography (MDCT), and to prospectively validate performance of the model. Total 60 patients undergoing radical nephrectomy from 2011 to 2013 participated, including a development cohort of 39 patients and an external validation cohort of 21 patients. RCV was calculated by voxel count using software (Vincent, FUJIFILM). Renal function before and after radical nephrectomy was assessed via the estimated glomerular filtration rate (eGFR). Factors affecting postoperative eGFR were examined by regression analysis to develop the novel model for predicting postoperative eGFR with a backward elimination method. The predictive model was externally validated and the performance of the model was compared with that of the previously reported models. The postoperative eGFR value was associated with age, preoperative eGFR, preserved renal parenchymal volume (RPV), preserved RCV, % of RPV alteration, and % of RCV alteration (p volumetry and clinical indices might yield an important tool for predicting postoperative renal function.

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

International Nuclear Information System (INIS)

Choi, Bo Yoon; Lee, Jong Seok; Lee, Joon Woo; Myung, Jae Sung; Sim, Jung Suk; Seong, Chang Kyu; Kim, Seung Hyup; Choi, Guk Myeong; Chi, Seong Whi

2000-01-01

estimating renal functional status but also a means of differentiating between patients with renal parenchymal disease and those who are normal

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

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Samia Rafael Yamashita

2015-02-01

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

Post-Discharge Worsening Renal Function in Patients with Type 2 Diabetes and Recent Acute Coronary Syndrome.

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Morici, Nuccia; Savonitto, Stefano; Ponticelli, Claudio; Schrieks, Ilse C; Nozza, Anna; Cosentino, Francesco; Stähli, Barbara E; Perrone Filardi, Pasquale; Schwartz, Gregory G; Mellbin, Linda; Lincoff, A Michael; Tardif, Jean-Claude; Grobbee, Diederick E

2017-09-01

Worsening renal function during hospitalization for an acute coronary syndrome is strongly predictive of in-hospital and long-term outcome. However, the role of post-discharge worsening renal function has never been investigated in this setting. We considered the placebo cohort of the AleCardio trial comparing aleglitazar with standard medical therapy among patients with type 2 diabetes mellitus and a recent acute coronary syndrome. Patients who had died or had been admitted to hospital for heart failure before the 6-month follow-up, as well as patients without complete renal function data, were excluded, leaving 2776 patients for the analysis. Worsening renal function was defined as a >20% reduction in estimated glomerular filtration rate from discharge to 6 months, or progression to macroalbuminuria. The Cox regression analysis was used to determine the prognostic impact of 6-month renal deterioration on the composite of all-cause death and hospitalization for heart failure. Worsening renal function occurred in 204 patients (7.34%). At a median follow-up of 2 years the estimated rates of death and hospitalization for heart failure per 100 person-years were 3.45 (95% confidence interval [CI], 2.46-6.36) for those with worsening renal function, versus 1.43 (95% CI, 1.14-1.79) for patients with stable renal function. At the adjusted analysis worsening renal function was associated with the composite endpoint (hazard ratio 2.65; 95% CI, 1.57-4.49; P acute coronary syndromes with normal or mildly depressed renal function, and is a strong predictor of adverse cardiovascular events. Copyright © 2017 Elsevier Inc. All rights reserved.

The renal quantitative scintillation camera study for determination of renal function

International Nuclear Information System (INIS)

Thompson, I.M. Jr.; Boineau, F.G.; Evans, B.B.; Schlegel, J.U.

1983-01-01

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

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

DEFF Research Database (Denmark)

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

2013-01-01

Background. Several antiretroviral agents (ARVs) are associated with chronic renal impairment, but the extent of such adverse events among human immunodeficiency virus (HIV)-positive persons with initially normal renal function is unknown.Methods. D:A:D study participants with an estimated...... glomerular filtration rate (eGFR) of ≥90 mL/min after 1 January 2004 were followed until they had a confirmed eGFR of ≤70 mL/min (the threshold below which we hypothesized that renal interventions may begin to occur) or ≤60 mL/min (a value indicative of moderately severe chronic kidney disease [CKD...... [95% CI, 1.16-1.28], respectively). Associations were unaffected by censoring for concomitant ARV use but diminished after discontinuation of these ARVs.Conclusions. Tenofovir, ritonavir-boosted atazanavir, and ritonavir-boosted lopinavir use were independent predictors of chronic renal impairment...

Renal functional reserve and renal hemodynamics in hypertensive patients.

Science.gov (United States)

Gaipov, Abduzhappar; Solak, Yalcin; Zhampeissov, Nurlan; Dzholdasbekova, Aliya; Popova, Nadezhda; Molnar, Miklos Z; Tuganbekova, Saltanat; Iskandirova, Elmira

2016-10-01

The renal functional reserve (RFR) is the ability of the kidneys to increase renal plasma flow and glomerular filtration rate (GFR) in response to protein intake. It is a measure of functional and anatomic integrity of nephrons. It is not known what relation between RFR and kidney Doppler parameters. We aimed to study the relation between the RFR and renal hemodynamic parameters in hypertensive patients with and without nephropathy who had normal kidney function. Twenty-four hypertensive subjects with nephropathy (HTN-n, n = 10) and hypertension without nephropathy (HTN, n = 14) were included in the study. Control group included 11 healthy subjects. Baseline GFR (GFR1) and GFR after intake of egg protein 1 mg/kg of body weight were determined (GFR2). RFR was calculated by the following formula: (GFR2-GFR1)/GFR1 × 100%. Doppler ultrasonography was performed. Arterial blood pressure (BP), body mass index (BMI), and estimated GFR were also recorded. HTN and HTN-n groups had impaired levels of RFR compared with controls (p < 0.05), significantly decreased value of flow velocity parameters (Vmax, Vmin), and increased RRI compared with controls. There was significant negative correlation of RFR with blood pressure levels (sBP, r = -0.435, p = 0.009; dBP, r = -0.504, p = 0.002), RRI (r = -0.456, p = 0.008), micro albuminuria (MAU, r = -0.366, p = 0.031) and positive correlation with Vmax and Vmin (r = 0.556, p = 0.001 and r = 0.643, respectively, p < 0.001). Linear regression showed that RRI and MAU were independent predictors of decreased RFR. RFR is lower in hypertensive patients despite near-normal level of kidney function and is related to particular level of BP. RRI and MAU were independent predictors of decreased RFR.

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

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

2014-07-15

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

Kidney function changes with aging in adults: comparison between cross-sectional and longitudinal data analyses in renal function assessment.

Science.gov (United States)

Chung, Sang M; Lee, David J; Hand, Austin; Young, Philip; Vaidyanathan, Jayabharathi; Sahajwalla, Chandrahas

2015-12-01

The study evaluated whether the renal function decline rate per year with age in adults varies based on two primary statistical analyses: cross-section (CS), using one observation per subject, and longitudinal (LT), using multiple observations per subject over time. A total of 16628 records (3946 subjects; age range 30-92 years) of creatinine clearance and relevant demographic data were used. On average, four samples per subject were collected for up to 2364 days (mean: 793 days). A simple linear regression and random coefficient models were selected for CS and LT analyses, respectively. The renal function decline rates per year were 1.33 and 0.95 ml/min/year for CS and LT analyses, respectively, and were slower when the repeated individual measurements were considered. The study confirms that rates are different based on statistical analyses, and that a statistically robust longitudinal model with a proper sampling design provides reliable individual as well as population estimates of the renal function decline rates per year with age in adults. In conclusion, our findings indicated that one should be cautious in interpreting the renal function decline rate with aging information because its estimation was highly dependent on the statistical analyses. From our analyses, a population longitudinal analysis (e.g. random coefficient model) is recommended if individualization is critical, such as a dose adjustment based on renal function during a chronic therapy. Copyright © 2015 John Wiley & Sons, Ltd.

Laparoscopic partial nephrectomy for hilar tumors: oncologic and renal functional outcomes.

Science.gov (United States)

George, Arvin K; Herati, Amin S; Rais-Bahrami, Soroush; Waingankar, Nikhil; Kavoussi, Louis R

2014-01-01

To present our experience with laparoscopic partial nephrectomy (LPN) for hilar tumors and evaluate intermediate oncologic and renal functional outcomes. A retrospective review of LPN cases performed in 488 patients was performed. Hilar lesions were defined as renal cortical tumors in direct physical contact with the renal artery, vein, or both, as identified on preoperative imaging and confirmed intraoperatively. The clinicopathologic parameters, perioperative course, complications, and oncologic and 6-month renal functional outcomes were analyzed. A total of 488 patients underwent LPN, of which 43 were hilar. The mean tumor size for hilar and nonhilar tumors was 3.6 cm and 3.1 cm, respectively. The mean operative time was shorter for hilar as compared with nonhilar tumors (129.1 minutes vs 141.8 minutes). Mean estimated blood loss was greater in LPN for hilar tumors (311.65 mL vs 298.4 mL). There were no statistically significant differences noted in any of the perioperative parameters investigated despite a higher nephrometry complexity score in the hilar group. Change in estimated glomerular filtration rate at 6 months showed a decrease of 10.9 mL/min and 8.8 mL/min for hilar and nonhilar tumors, respectively (P = NS). There was 1 recurrence detected in the hilar group, with a median follow-up of 41.6 months. In the hands of an experienced laparoscopist, LPN can safely be performed for hilar tumors, with preservation of perioperative outcomes and durable renal functional and oncologic outcomes. Copyright © 2014 Elsevier Inc. All rights reserved.

An acute fall in estimated glomerular filtration rate during treatment with losartan predicts a slower decrease in long-term renal function

DEFF Research Database (Denmark)

Holtkamp, Frank A; de Zeeuw, Dick; Thomas, Merlin C

2011-01-01

initial fall in eGFR had a significant lower long-term eGFR slope compared to those with a moderate fall or rise. This relationship was independent of other risk markers or change in risk markers for progression of renal disease such as blood pressure and albuminuria. Thus, the greater the acute fall in e......Intervention in the renin-angiotensin-aldosterone-system (RAAS) is associated with slowing the progressive loss of renal function. During initiation of therapy, however, there may be an acute fall in glomerular filtration rate (GFR). We tested whether this initial fall in GFR reflects a renal...... a significantly greater acute fall in estimated (eGFR) during the first 3 months compared to patients assigned to placebo, but a significantly slower long-term mean decline of eGFR thereafter. A large interindividual difference, however, was noticed in the acute eGFR change. When patients were divided...

Changes in renal function after discontinuation of vitamin D analogues in advanced chronic kidney disease.

Science.gov (United States)

Caravaca, Francisco; Caravaca-Fontán, Fernando; Azevedo, Lilia; Luna, Enrique

In routine clinical practice, the prescription of vitamin D analogues (VDA) in patients with chronic kidney disease (CKD) is often associated with a decline of the estimated renal function. The reason for this is not fully understood. To analyse the effects of VDA discontinuation in advanced CKD and to determine the factors associated with changes in renal function. Retrospective cohort study of adult patients with advanced CKD. The case subgroup was treated with VDA and this medication was discontinued at baseline (the first visit). The control subgroup was not treated with VDA and they were selected according to comparability principles for CKD progression by propensity score matching. The primary outcome measure was a change to both the estimated glomerular filtration rate (MDRD-GFR) and the measured glomerular filtration rate (mGFR by combined creatinine and urea clearances). Baseline parameters related to mineral metabolism and creatinine generation were analysed as potential determinants of renal function changes. The study sample consisted of 67 cases and 67 controls. Renal function improved in 67% of cases and worsened in 72% of controls (p<0.0001). Changes in MDRD-GFR for the case subgroup and the control subgroup were +0.455±0.997 vs. -0.436±1.103ml/min/1.73 m 2 /month (p<0.0001), respectively. Total creatinine excretion was slightly higher in cases than in controls but the difference was not significant. According to multivariate logistic and linear regression analyses, baseline total serum calcium was one of the best determinants of both renal function recovery (Odds ratio=3.49; p=0.001), and of the extent of renal function recovery (beta=0.276; p=0.001). Discontinuation of VDA treatment in CKD patients is associated with significant recovery of estimated renal function. The extent of these changes is mainly associated with baseline total serum calcium. Copyright © 2017 Sociedad Española de Nefrología. Published by Elsevier España, S.L.U. All

Renal function study assessed by 99mTc-DMSA renal scintigraphy before and after PNL

International Nuclear Information System (INIS)

Sakurai, Masaki; Hioki, Takuichi; Okuno, Toshiyuki; Sugimura, Yoshiki; Yamakawa, Kensuke; Yanagawa, Makoto; Tajima, Kazuhiro; Tochigi, Hiromi; Kawamura, Juichi

1990-01-01

99m Tc-DMSA renal scintigraphy was carried out in 54 patients with unilateral renal stones before and after PNL. Four to 8 weeks after PNL the DMSA renal uptake significantly decreased to 17.2±6.0% from 18.2±6.7% before PNL. DMSA renal uptake did not change in the contralateral side. Since in some patients changes in the DMSA renal uptake of 5-7% were observed after PNL not only in the PNL side but also in the contralateral side, the renal function was assessed by the formula: DMSA renal uptake in the PNL side/DMSA renal uptake in the contralateral side, and the change of this ratio was evaluated in 44 patients, in whom the renal DMSA uptake in the PNL side was less than two times that in the contralateral side. The DMSA renal uptake ratio decreased to 95.6±8.7% from the base line 4-8 weeks after PNL. This change was statistically significant. Some functional risks such as massive bleeding with PNL, the fever after PNL and the number of nephrostomy tract did not affect the decrease in the renal function. In 29 patients in whom renal function was reevaluated one year after PNL, the DMSA renal uptake ratio significantly decreased to 94.2±9.6% from the base line 4-8 weeks after PNL. But the ratio significantly improved to 99.6±11.6% about one year after PNL. In two patients with a cold area on the renal image, the renal function of the operated side still remained at about 80% levels from the base line even one year after PNL. It is concluded that although renal function slightly decreased 4-8 weeks after PNL, it is expected to improve within one year after PNL. But in the case with a cold area on the renal image, the complete functional recovery would not be expected. 99m Tc-DMSA renal scintigraphy is a useful adjunct to evaluate the renal function before and after PNL. (author)

Impaired left ventricular systolic function and increased brachial-ankle pulse-wave velocity are independently associated with rapid renal function progression.

Science.gov (United States)

Chen, Szu-Chia; Lin, Tsung-Hsien; Hsu, Po-Chao; Chang, Jer-Ming; Lee, Chee-Siong; Tsai, Wei-Chung; Su, Ho-Ming; Voon, Wen-Chol; Chen, Hung-Chun

2011-09-01

Heart failure and increased arterial stiffness are associated with declining renal function. Few studies have evaluated the association between left ventricular ejection fraction (LVEF) and brachial-ankle pulse-wave velocity (baPWV) and renal function progression. The aim of this study was to assess whether LVEFfunction was estimated by eGFR slope. The renal end point was defined as ≥25% decline in eGFR. Clinical and echocardiographic parameters were compared and analyzed. After a multivariate analysis, serum hematocrit was positively associated with eGFR slope, and diabetes mellitus, baPWV (P=0.031) and LVEFfunction decline and progression to the renal end point.

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

Science.gov (United States)

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

2016-01-15

Abnormal renal function is common in acute and chronic congestive heart failure (CHF) and is related to the severity of congestion. However, treatment of congestion often leads to worsening renal function. Our objective was to explore basal determinants of renal function and their response to hemodynamic interventions. Thirty-seven patients without CHF and 59 patients with chronic CHF (ejection fraction; 23 ± 8%) underwent right heart catheterization, measurements of glomerular filtration rate (GFR; inulin) and renal plasma flow (RPF; para-aminohippurate), and radiotracer estimates of renal sympathetic activity. A subset (26 without, 36 with CHF) underwent acute pharmacological intervention with dobutamine or nitroprusside. We explored the relationship between baseline and drug-induced hemodynamic changes and changes in renal function. In CHF, there was an inverse relationship among right atrial mean pressure (RAM) pressure, RPF, and GFR. By contrast, mean arterial pressure (MAP), cardiac index (CI), and measures of renal sympathetic activity were not significant predictors. In those with CHF there was also an inverse relationship among the drug-induced changes in RAM as well as pulmonary artery mean pressure and the change in GFR. Changes in MAP and CI did not predict the change in GFR in those with CHF. Baseline values and changes in RAM pressure did not correlate with GFR in those without CHF. In the CHF group there was a positive correlation between RAM pressure and renal sympathetic activity. There was also an inverse relationship among RAM pressure, GFR, and RPF in patients with chronic CHF. The observation that acute reductions in RAM pressure is associated with an increase in GFR in patients with CHF has important clinical implications. Copyright © 2016 the American Physiological Society.

Assessment of relative individual renal function based on DMSA uptake corrected for renal size

International Nuclear Information System (INIS)

Estorch, M.; Camacho, V.; Tembl, A.; Mena, I.; Hernandez, A.; Flotats, A.; Carrio, I.; Torres, G.; Prat, L.

2002-01-01

Decreased relative renal DMSA uptake can be a consequence of abnormal kidney size, associated with normal or impaired renal function. The quantification of relative renal function based on DMSA uptake in both kidneys is an established method for the assessment of individual renal function. Aim: To assess relative renal function by means of quantification of renal DMSA uptake corrected for kidney size. Results were compared with relative renal DMSA uptake without size correction, and were validated against the absolute renal DMSA uptake. Material and Methods: Four-hundred-forty-four consecutive patients (147 adults, mean age 14 years) underwent a DMSA study for several renal diseases. The relative renal function, based on the relative DMSA uptake uncorrected and corrected for renal size, and the absolute renal DMSA uptake were calculated. In order to relate the relative DMSA uptake uncorrected and corrected for renal size with the absolute DMSA uptake, subtraction of uncorrected (SU) and corrected (SC) relative uptake percentages of each pair of kidneys was obtained, and these values were correlated to the matched subtraction percentages of absolute uptake (SA). If the individual relative renal function is normal (45%-55%), the subtraction value is less or equal to 10%. Results: In 227 patients (51%) the relative renal DMSA uptake value was normal either uncorrected or corrected for renal size (A), and in 149 patients (34%) it was abnormal by both quantification methods (B). Seventy-seven patients (15%) had the relative renal DMSA uptake abnormal only by the uncorrected method (C). Subtraction value of absolute DMSA uptake percentages was not significantly different of subtraction value of relative DMSA uptake percentages corrected for renal size when relative uncorrected uptake was abnormal and corrected normal. where * p<0.0001, and p=NS. Conclusion: When uncorrected and corrected relative DMSA uptake are abnormal, the absolute uptake is also impaired, while when

Preeclampsia and Long-term Renal Function in Women Who Underwent Kidney Transplantation.

Science.gov (United States)

Vannevel, Valerie; Claes, Kathleen; Baud, David; Vial, Yvan; Golshayan, Delaviz; Yoon, Eugene W; Hodges, Ryan; Le Nepveu, Anne; Kerr, Peter G; Kennedy, Claire; Higgins, Mary; Resch, Elisabeth; Klaritsch, Philipp; Van Mieghem, Tim

2018-01-01

Preeclampsia often complicates pregnancies after maternal kidney transplantation. We aimed to assess whether preeclampsia is associated with kidney function decline either during the pregnancy or in the long term. We performed an international multicenter retrospective cohort study. Renal function at conception, pregnancy outcomes, and short- and long-term graft outcomes were collected for women who were pregnant after renal transplantation and had transplant and obstetric care at the participating centers. In women who had multiple pregnancies during the study period, only the last pregnancy was included. Univariate and multivariable analyses were performed. We retrieved pregnancy outcomes and long-term renal outcomes for 52 women. Chronic hypertension was present at baseline in 27%. Mean estimated glomerular filtration rate (GFR) at start of pregnancy was 52.4±17.5 mL/min/1.73 m. Mean estimated GFR at delivery was 47.6±21.6 mL/min/1.73 m, which was significantly lower than at conception (P=.03). Twenty women (38%) developed preeclampsia. In multivariable analysis, women who developed preeclampsia had a 10.7-mL/min/1.73 m higher drop in estimated GFR between conception and delivery than women who did not develop preeclampsia (P=.02). Long-term estimated GFR follow-up was obtained at a median of 5.8 years (range 1.3-27.5 years). Mean estimated GFR at last follow-up was 38±23 mL/kg/1.73 m. Seventeen women (33%) experienced graft loss over the follow-up period. Incidence of graft loss was similar in women with and without preeclampsia in their last pregnancy (30% and 34%, respectively; P=.99). In multivariable analysis, the decrease in estimated GFR between conception and last follow-up was similar in women who experienced preeclampsia during pregnancy and those who did not (difference -2.69 mL/min/1.73 m, P=.65). Preeclampsia commonly complicates pregnancies after renal transplantation but is not associated with long-term renal dysfunction or graft loss.

Detecting reduced renal function in children

DEFF Research Database (Denmark)

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

2013-01-01

Background The aim of this study was to compare the ability of renal indicators [serum creatinine (SCr), cystatin C (SCysC)] and glomerular filtration rate (GFR)-models to discriminate normal and reduced renal function. As a single cut-off level will always lead to false classifications, we propose...... function was defined as a GFR ofcreatinine (SCr-ratio), and eight published GFR-models were compared for their ability to correctly classify renal function as normal or reduced. Cut-off levels were determined so as to give 99 % certainty outside the gray zone...

Prognosis for recovery of function in acute renal failure

International Nuclear Information System (INIS)

Harwood, T.H. Jr.; Hiesterman, D.R.; Robinson, R.G.; Cross, D.E.; Whittier, F.C.; Diederich, D.A.; Grantham, J.J.

1976-01-01

Twenty-four survivors of acute, nonobstructive, nonnephritic renal failure had a renal scan using iodohippurate sodium I 131 performed early in the acute illness. Scans were judged according to whether the renal images were prominent, faint, or absent during the first 30 minutes after intravenous injection of 100 to 250 microcuries of iodohippurate sodium I 131. All ten patients with prominent renal images attained life-sustaining renal function with an average postrecovery creatinine clearance of 80 ml/min. Of the seven patients with faint renal images, six recovered life-sustaining renal function (average creatinine clearance of 39 ml/min), and one required chronic hemodialysis. Seven patients had no renal image initially; four recovered life-sustaining renal function with an average creatinine clearance of 25 ml/min; three required chronic hemodialysis. We conclude that, for patients with acute renal failure, the appearance of the renal image obtained using this substance is an important indicator of renal viability and of the likelihood for functional recovery

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

DEFF Research Database (Denmark)

Kümler, Thomas; Gislason, Gunnar H; Kober, Lars

2011-01-01

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

Renal endothelial function and blood flow predict the individual susceptibility to adriamycin-induced renal damage

NARCIS (Netherlands)

Ochodnicky, Peter; Henning, Robert H.; Buikema, Hendrik; Kluppel, Alex C. A.; van Wattum, Marjolein; de Zeeuw, Dick; van Dokkum, Richard P. E.

2009-01-01

Susceptibility to renal injury varies among individuals. Previously, we found that individual endothelial function of healthy renal arteries in vitro predicted severity of renal damage after 5/6 nephrectomy. Here we hypothesized that individual differences in endothelial function in vitro and renal

Renal rescue of dopamine D2 receptor function reverses renal injury and high blood pressure

Science.gov (United States)

Konkalmatt, Prasad R.; Asico, Laureano D.; Zhang, Yanrong; Yang, Yu; Drachenberg, Cinthia; Zheng, Xiaoxu; Han, Fei; Jose, Pedro A.; Armando, Ines

2016-01-01

Dopamine D2 receptor (DRD2) deficiency increases renal inflammation and blood pressure in mice. We show here that long-term renal-selective silencing of Drd2 using siRNA increases renal expression of proinflammatory and profibrotic factors and blood pressure in mice. To determine the effects of renal-selective rescue of Drd2 expression in mice, the renal expression of DRD2 was first silenced using siRNA and 14 days later rescued by retrograde renal infusion of adeno-associated virus (AAV) vector with DRD2. Renal Drd2 siRNA treatment decreased the renal expression of DRD2 protein by 55%, and DRD2 AAV treatment increased the renal expression of DRD2 protein by 7.5- to 10-fold. Renal-selective DRD2 rescue reduced the expression of proinflammatory factors and kidney injury, preserved renal function, and normalized systolic and diastolic blood pressure. These results demonstrate that the deleterious effects of renal-selective Drd2 silencing on renal function and blood pressure were rescued by renal-selective overexpression of DRD2. Moreover, the deleterious effects of 45-minute bilateral ischemia/reperfusion on renal function and blood pressure in mice were ameliorated by a renal-selective increase in DRD2 expression by the retrograde ureteral infusion of DRD2 AAV immediately after the induction of ischemia/reperfusion injury. Thus, 14 days after ischemia/reperfusion injury, the renal expression of profibrotic factors, serum creatinine, and blood pressure were lower in mice infused with DRD2 AAV than in those infused with control AAV. These results indicate an important role of renal DRD2 in limiting renal injury and preserving normal renal function and blood pressure. PMID:27358912

Single injection techniques in determining age-related changes in porcine renal function

International Nuclear Information System (INIS)

Robbins, M.E.C.

1984-01-01

Glomerular filtration rate (GFR) and effective renal plasma flow (ERPF) were determined in 32 anaesthetised female Large White pigs, aged 4-24 months, from the plasma disappearance curves of [sup(99m)Tc]DTPA and [ 131 I]hippuran respectively. Clearance was also monitored by external counting over the heart. GFR and ERPF increased markedly with age in pigs up to 12 months old, reaching mean values of 242.06 +- 5.89 and 919.39 +- 79.01 mL/min. In pigs aged 12-24 months ERPF increased slightly but renal function remained essentially unchanged after 1 yr of age. These results for renal function were similar to previous estimates, using continuous infusion techniques inferring that GFR and ERPF could be accurately monitored using single injection procedures. (author)

Individual renal function study using dynamic computed tomography

International Nuclear Information System (INIS)

Fukuda, Yutaka; Kiya, Keiichi; Suzuki, Yoshiharu

1990-01-01

Dynamic CT scans of individual kindneys were obtained after an intravenous bolus injection of contrast agent. Time-density curves measured from the renal cortex, medulla and pelvis revealed the changes in density produced by the contrast agent reflecting the differential phase of renal function. Renal cortical density increased rapidly after bolus administration and then renal medullary and pelvic density increased continuously. In analyzing time-density curve, the cortico-medullary junction time, which is the time when the cortical and medullary curves cross was 57±8 seconds in patients with normal renal function. The cortico-medullary junction time was delayed in patient with decreased glomerular filtration rate. The cortico-pelvic junction time, which is the time when the cortical and pelvic curves cross was 104±33 seconds in patients with normal renal function. The cortico-pelvic junction time was delayed in patients with declined urinary concentrating capacity. In patients with unilateral renal agenesis and patients who were treated surgically by ureteral sprits, the relationship between individual renal functions and these junction times was examined. As a result of study there were inversely significant correlations between C-M junction time and unilateral GFR and between C-P junction time and urinary concentrating capacity. These studies indicate that dynamic CT scanning is an effective way that individual renal function can be monitored and evaluated. (author)

MRI to assess renal structure and function.

Science.gov (United States)

Artunc, Ferruh; Rossi, Cristina; Boss, Andreas

2011-11-01

In addition to excellent anatomical depiction, MRI techniques have expanded to study functional aspects of renal physiology, such as renal perfusion, glomerular filtration rate (GFR) or tissue oxygenation. This review will focus on current developments with an emphasis on clinical applicability. The method of GFR determination is largely heterogeneous and still has weaknesses. However, the technique of employing liver disappearance curves has been shown to be accurate in healthy persons and patients with chronic kidney disease. In potential kidney donors, complete evaluation of kidney anatomy and function can be accomplished in a single-stop investigation. Techniques without contrast media can be utilized to measure renal tissue oxygenation (blood oxygen level-dependent MRI) or perfusion (arterial spin labeling) and could aid in the diagnosis and treatment of ischemic renal diseases, such as renal artery stenosis. Diffusion imaging techniques may provide information on spatially restricted water diffusion and tumor cellularity. Functional MRI opens new horizons in studying renal physiology and pathophysiology in vivo. Although extensively utilized in research, labor-intensive postprocessing and lack of standardization currently limit the clinical applicability of functional MRI. Further studies are necessary to evaluate the clinical value of functional magnetic resonance techniques for early discovery and characterization of kidney disease.

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

International Nuclear Information System (INIS)

Muto, Natalia Sayuri; Kamishima, Tamotsu; Harris, Ardene A.; Kato, Fumi; Onodera, Yuya; Terae, Satoshi; Shirato, Hiroki

2011-01-01

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

Mercaptoacetyltriglycine-3 renogram is not superior to estimated glomerular filtration rate measurement for the prediction of long-term renal function after nephrectomy

International Nuclear Information System (INIS)

Kanamaru, Hiroshi; Yamamoto, Masakazu; Nagahama, Kanji

2011-01-01

The objective of this study was to evaluate the clinical usefulness of effective renal plasma flow (ERPF) measured using preoperative mercaptoacetyltriglycine-3 (MAG3) renogram for the prediction of chronic renal insufficiency after nephrectomy. A total of 47 patients underwent preoperative MAG3 renal scintigraphy and subsequent unilateral nephrectomy. Correlations between the 5-year postoperative estimated glomerular filtration rate (eGFR) and the preoperative ERPF of the contralateral kidney (cERPF), ERPF of the diseased kidney (dERPF), total ERPF (tERPF), cERPF to dERPF ratio, serum creatinine (sCr) level, eGFR, as well as the influence of preoperative comorbidities (diabetes, hypertension) on the postoperative eGFR, were evaluated with both univariate and multivariate analyses. Multiple linear regression analysis showed that preoperative cERPF significantly correlated with postoperative eGFR. However, a much stronger correlation was observed between the preoperative and postoperative eGFR. Multiple logistic regression analysis showed that only preoperative eGFR was a significant predicator of the development of advanced-stage chronic kidney disease (CKD). Preoperative MAG3 renogram is not superior to eGFR measurement as a prognostic indicator of long-term renal function after unilateral nephrectomy. (author)

A simple estimation of the renal plasma flow

International Nuclear Information System (INIS)

Shinpo, Takako

1987-01-01

The renal plasma flow was determined conventionally by the excretive ratio to urine using a 131 I-Hippuran renogram. In this report, we proposed the renal clearance, the product of the disappearance rate coefficient and the maximum counts of the bladder, for the simple quantitative value of renal plasma flow. The disappearance rate coefficient was calculated by approximating the exponential function of the initial slope from the disappearance curve of the heart. The renal clearances was compared with the renal plasma flow calculated by the conventional method. The results gave a high correlation coefficient of r = 0.91. The renal clearances can be calculated easily and it offers useful renogram information. (author)

The natural history of renal function after surgical management of renal cell carcinoma: Results from the Canadian Kidney Cancer Information System.

Science.gov (United States)

Mason, Ross; Kapoor, Anil; Liu, Zhihui; Saarela, Olli; Tanguay, Simon; Jewett, Michael; Finelli, Antonio; Lacombe, Louis; Kawakami, Jun; Moore, Ronald; Morash, Christopher; Black, Peter; Rendon, Ricardo A

2016-11-01

Patients who undergo surgical management of renal cell carcinoma (RCC) are at risk for chronic kidney disease and its sequelae. This study describes the natural history of renal function after radical and partial nephrectomy and explores factors associated with postoperative decline in renal function. This is a multi-institutional cohort study of patients in the Canadian Kidney Cancer Information System who underwent partial or radical nephrectomy for RCC. Estimated glomerular filtration rate (eGFR) and stage of chronic kidney disease were determined preoperatively and at 3, 12, and 24 months postoperatively. Linear regression was used to determine the association between postoperative eGFR and type of surgery (radical vs. partial), duration of ischemia, ischemia type (warm vs. cold), and tumor size. With a median follow-up of 26 months, 1,379 patients were identified from the Canadian Kidney Cancer Information System database including 665 and 714 who underwent partial and radical nephrectomy, respectively. Patients undergoing radical nephrectomy had a lower eGFR (mean = 19ml/min/1.73m 2 lower) at 3, 12, and 24 months postoperatively (Prenal function occurred early and remained stable throughout follow-up. A lower preoperative eGFR and increasing age were also associated with a lower postoperative eGFR (P0.05). Severe renal failure (eGFRrenal function remains stable in patients undergoing surgery for RCC. Patients undergoing radical nephrectomy have a greater long-term reduction in renal function compared with those undergoing partial nephrectomy. Ischemia duration and type are not predictive of postoperative renal function when adhering to generally short ischemia durations. Copyright © 2016 Elsevier Inc. All rights reserved.

Renal endothelial function and blood flow predict the individual susceptibility to adriamycin-induced renal damage

NARCIS (Netherlands)

Ochodnicky, Peter; Henning, Robert H.; Buikema, Hendrik; Kluppel, Alex C. A.; van Wattum, Marjolein; de Zeeuw, Dick; van Dokkum, Richard P. E.

Background. Susceptibility to renal injury varies among individuals. Previously, we found that individual endothelial function of healthy renal arteries in vitro predicted severity of renal damage after 5/6 nephrectomy. Here we hypothesized that individual differences in endothelial function in

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

Energy Technology Data Exchange (ETDEWEB)

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

2013-08-15

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

Fetal programming of renal function.

Science.gov (United States)

Dötsch, Jörg; Plank, Christian; Amann, Kerstin

2012-04-01

Results from large epidemiological studies suggest a clear relation between low birth weight and adverse renal outcome evident as early as during childhood. Such adverse outcomes may include glomerular disease, hypertension, and renal failure and contribute to a phenomenon called fetal programming. Other factors potentially leading to an adverse renal outcome following fetal programming are maternal diabetes mellitus, smoking, salt overload, and use of glucocorticoids during pregnancy. However, clinical data on the latter are scarce. Here, we discuss potential underlying mechanisms of fetal programming, including reduced nephron number via diminished nephrogenesis and other renal (e.g., via the intrarenal renin-angiotensin-aldosterone system) and non-renal (e.g., changes in endothelial function) alterations. It appears likely that the outcomes of fetal programming may be influenced or modified postnatally, for example, by the amount of nutrients given at critical times.

Peritumoral Artery Scoring System: a Novel Scoring System to Predict Renal Function Outcome after Laparoscopic Partial Nephrectomy.

Science.gov (United States)

Zhang, Ruiyun; Wu, Guangyu; Huang, Jiwei; Shi, Oumin; Kong, Wen; Chen, Yonghui; Xu, Jianrong; Xue, Wei; Zhang, Jin; Huang, Yiran

2017-06-06

The present study aimed to assess the impact of peritumoral artery characteristics on renal function outcome prediction using a novel Peritumoral Artery Scoring System based on computed tomography arteriography. Peritumoral artery characteristics and renal function were evaluated in 220 patients who underwent laparoscopic partial nephrectomy and then validate in 51 patients with split and total glomerular filtration rate (GFR). In particular, peritumoral artery classification and diameter were measured to assign arteries into low, moderate, and high Peritumoral Artery Scoring System risk categories. Univariable and multivariable logistic regression analyses were then used to determine risk factors for major renal functional decline. The Peritumoral Artery Scoring System and four other nephrometry systems were compared using receiver operating characteristic curve analysis. The Peritumoral Artery Scoring System was significantly superior to the other systems for predicting postoperative renal function decline (p system was a superior independent predictor of estimated glomerular filtration rate (eGFR) decline (area-under-the-curve = 0.865, p renal function outcome after laparoscopic partial nephrectomy.

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

Studies on renal function in the elderly by analysis of radioisotope renal images

International Nuclear Information System (INIS)

Ohishi, Yukihiko

1990-01-01

This study was carried out to evaluate the potential of radionuclide renal imagings for examining senile renal function in a total of 178 subjects. Single photon emission computed tomography (SPECT) with Tc-99m-dimercaptosuccinic acid (Tc-DMSA) was performed in the senile group (60-87 years) and in the adult group to determine renal uptake rate of Tc-DMSA and renal volume. Renography studies with I-131 hippuran (n=100) and Tc-99m diethylentriaminepentaacetic acid (Tc-DTPA) (n=20) were also performed for deconvolution analysis. Mean transit time (MTT) was mainly assessed as one of the retention function parameters. Blood residual rates (R15%) at fifteen minutes were also investigated. Renal volume and renal uptake rate for healthy persons were significantly lower in the senile group (n=17) than the adult group (n=24), 205±50 ml vs 225±27 ml; and 22±5% vs 26±2%. I-133 hippuran renography in healthy persons (n=35) showed a tendency toward higher MTT values with aging; however, there was no significant difference among age groups. R15%, obtained by I-133 hippuran renograms, tended to be higher with aging in age groups of persons younger than 70 years. A decreased number of effective nephrons was considered to result in higher R15% values even when aged persons had normal MTT values of I-131 hippuran. Split renal function values for healthy persons, calculated by the two radionuclide imagings, were lower in the senile group than the adult group, suggesting the usefulness of radionuclide imagings in renal function examination. (N.K.)

A Mathematical Method to Calculate Tumor Contact Surface Area: An Effective Parameter to Predict Renal Function after Partial Nephrectomy.

Science.gov (United States)

Hsieh, Po-Fan; Wang, Yu-De; Huang, Chi-Ping; Wu, Hsi-Chin; Yang, Che-Rei; Chen, Guang-Heng; Chang, Chao-Hsiang

2016-07-01

We proposed a mathematical formula to calculate contact surface area between a tumor and renal parenchyma. We examined the applicability of using contact surface area to predict renal function after partial nephrectomy. We performed this retrospective study in patients who underwent partial nephrectomy between January 2012 and December 2014. Based on abdominopelvic computerized tomography or magnetic resonance imaging, we calculated the contact surface area using the formula (2*π*radius*depth) developed by integral calculus. We then evaluated the correlation between contact surface area and perioperative parameters, and compared contact surface area and R.E.N.A.L. (Radius/Exophytic/endophytic/Nearness to collecting system/Anterior/Location) score in predicting a reduction in renal function. Overall 35, 26 and 45 patients underwent partial nephrectomy with open, laparoscopic and robotic approaches, respectively. Mean ± SD contact surface area was 30.7±26.1 cm(2) and median (IQR) R.E.N.A.L. score was 7 (2.25). Spearman correlation analysis showed that contact surface area was significantly associated with estimated blood loss (p=0.04), operative time (p=0.04) and percent change in estimated glomerular filtration rate (p contact surface area and R.E.N.A.L. score independently affected percent change in estimated glomerular filtration rate (p contact surface area was a better independent predictor of a greater than 10% change in estimated glomerular filtration rate compared to R.E.N.A.L. score (AUC 0.86 vs 0.69). Using this simple mathematical method, contact surface area was associated with surgical outcomes. Compared to R.E.N.A.L. score, contact surface area was a better predictor of functional change after partial nephrectomy. Copyright © 2016 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

Renal function, time in therapeutic range and outcomes in warfarin-treated atrial fibrillation patients

DEFF Research Database (Denmark)

Bonde, Anders Nissen; Lip, Gregory Y H; Kamper, Anne-Lise

2017-01-01

Patients with severely reduced renal function have been excluded from randomized controlled trials of oral anticoagulation in atrial fibrillation (AF). Warfarin treatment in this population is controversial and data on anticoagulation control and the impact on adverse outcomes are needed. By indi......Patients with severely reduced renal function have been excluded from randomized controlled trials of oral anticoagulation in atrial fibrillation (AF). Warfarin treatment in this population is controversial and data on anticoagulation control and the impact on adverse outcomes are needed......) was calculated using the Rosendaal method. The risk of stroke and bleeding was estimated using multivariable Cox regression analyses with eGFR and TTR estimated time dependently throughout follow-up. We identified 10,423 warfarin-treated AF patients with available international normalized ratio and creatinine...

External Validation of Contact Surface Area as a Predictor of Postoperative Renal Function in Patients Undergoing Partial Nephrectomy.

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Haifler, Miki; Ristau, Benjamin T; Higgins, Andrew M; Smaldone, Marc C; Kutikov, Alexander; Zisman, Amnon; Uzzo, Robert G

2017-09-20

We sought to externally validate a mathematical formula for tumor contact surface area as a predictor of postoperative renal function in patients undergoing partial nephrectomy for renal cell carcinoma. We queried a prospectively maintained kidney cancer database for patients who underwent partial nephrectomy between 2014 and 2016. Contact surface area was calculated using data obtained from preoperative cross-sectional imaging. The correlation between contact surface area and perioperative variables was examined. The correlation between postoperative renal functional outcomes, contact surface area and the R.E.N.A.L. (radius, exophytic/endophytic properties, nearness of tumor to collecting system or sinus, anterior/posterior, location relative to polar lines and tumor touches main renal artery or vein) nephrometry score was also assessed. A total of 257 patients who underwent partial nephrectomy had sufficient data to enter the study. Median contact surface area was 14.5 cm 2 (IQR 6.2-36) and the median nephrometry score was 9 (IQR 7-10). Spearman correlation analysis showed that contact surface area correlated with estimated blood loss (r s = 0.42, p contact surface area and nephrometry score were independent predictors of the absolute change in the estimated glomerular filtration rate (each p contact surface area was a better predictor of a greater than 20% postoperative decline in the estimated glomerular filtration rate compared with the nephrometry score (AUC 0.94 vs 0.80). Contact surface area correlated with the change in postoperative renal function after partial nephrectomy. It can be used in conjunction with the nephrometry score to counsel patients about the risk of renal functional decline after partial nephrectomy. Copyright © 2018 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

Age-related features of renal function (on radiorenographic data)

International Nuclear Information System (INIS)

Korkushko, O.V.; Frajfel'd, V.Eh.; Belyj, A.A.

1986-01-01

Renal function of 91 healthy subjects aged 18-91 has been evaluated at radionuclide renography with the use of 131 I-Hippuran. Renal excretory function, effective renal plasma and blood flows were found to decrease annually by 0.09 ml/kg in ageing men and by 0.08 ml/kg in women. The use of new indices may be useful for evaluation of renal blood circulation, especially during hypo- or hypervolaemia is proposed. These are the index of renal circulation efficiency and the mean time of circulating blood volume transfer through renal blood vessels

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

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Mohamed Etafy

2015-01-01

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

Can pre-implantation biopsies predict renal allograft function in pediatric renal transplant recipients?

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Jameela A. Kari

2015-11-01

Full Text Available Objectives: To determine the utility of pre-implantation renal biopsy (PIB to predict renal allograft outcomes. Methods: This is a retrospective review of all patients that underwent PIB from January 2003 to December 2011 at the Great Ormond Street Hospital for Children in London, United Kingdom. Thirty-two male patients (56% aged 1.5-16 years (median: 10.2 at the time of transplantation were included in the study and followed-up for 33 (6-78 months. The results were compared with 33 controls. Results: The PIB showed normal histopathological findings in 13 patients (41%, mild chronic vascular changes in 8 (25%, focal tubular atrophy in one, moderate to severe chronic vascular change in 3, mild to moderate acute tubular damage in 6, and tissue was inadequate in one subject. Delayed graft function (DGF was observed in 3 patients; 2 with vascular changes in PIB, and one with normal histopathological findings. Two subjects with PIB changes lost their grafts. The estimated glomerular filtration rate at 3-, and 6-months post-transplantation was lower in children with abnormal PIB changes compared with those with normal PIB. There was one case of DGF in the control group, and 4 children lost their grafts including the one with DGF. Conclusion: Pre-implantation renal biopsy can provide important baseline information of the graft with implications on subsequent medical treatment for pediatric renal transplant recipients.

Evaluation the short term effects on serum creatinine concentration in patients with normal renal function, mild and moderate renal insufficiency after intravenous injection of gadopentetate dimeglumine

International Nuclear Information System (INIS)

Luo Jian; Liu Jing; Wang Xiaoying; Yang Xuedong; Jiang Xuexiang

2010-01-01

Objective: To explore the effects of gadopentetate dimeglumine injection on renal function. Methods: The study included 623 consecutive patients. Their serum creatinine concentrations before and within 3 days after injection of gadopentetate dimeglumine were analyzed. Their eGFR (estimated glomerular filtration rate) were calculated. Patients were divided into two groups according to their injection dose: group received single dose and group received double dose. Patients in each group were subdivided into three subgroups according to their eGFR: subgroup of normal renal function, subgroup of mild renal insufficiency and subgroup of moderate renal insufficiency. Paried sample t test and group design paired sample Rank Sum test were used for statistical analysis. Results: There was no adverse reaction or occurrence of acute renal insufficiency. The mean level of serum creatinine dropped from (74.0± 17.2) μmol/L to (71.5±19.0) μmol/L (t=5.39, P 0.05) in subgroup of mild renal insufficiency under group received double dose and increased from (118.3±15.3) μmol/L to (135.7±8.5) μmol/L (t=2.02, P<0.05) in subgroup of moderate renal insufficiency under group received double dose, the mean level of serum creatinine dropped in all other subgroups. Conclusions: Single dose gadopentetate dimeglumine is safe for patients with normal renal function and mild, moderate renal insufficiency in short term, but patients with abnormal renal function should be followed up after double dose injection. (authors)

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

International Nuclear Information System (INIS)

Ito, Katsuyoshi; Hayashida, Minoru; Izumitani, Shogo; Fujimine, Tomoko; Onishi, Takeo; Genba, Katsuhiro

2013-01-01

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

Comparing renal function preservation after laparoscopic radio frequency ablation assisted tumor enucleation and laparoscopic partial nephrectomy for clinical T1a renal tumor: using a 3D parenchyma measurement system.

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Zhu, Liangsong; Wu, Guangyu; Huang, Jiwei; Wang, Jianfeng; Zhang, Ruiyun; Kong, Wen; Xue, Wei; Huang, Yiran; Chen, Yonghui; Zhang, Jin

2017-05-01

To compare the renal function preservation between laparoscopic radio frequency ablation assisted tumor enucleation and laparoscopic partial nephrectomy. Data were analyzed from 246 patients who underwent laparoscopic radio frequency ablation assisted tumor enucleation and laparoscopic partial nephrectomy for solitary cT1a renal cell carcinoma from January 2013 to July 2015. To reduce the intergroup difference, we used a 1:1 propensity matching analysis. The functional renal parenchyma volume preservation were measured preoperative and 12 months after surgery. The total renal function recovery and spilt GFR was compared. Multivariable logistic analysis was used for predictive factors for renal function decline. After 1:1 propensity matching, each group including 100 patients. Patients in the laparoscopic radio frequency ablation assisted tumor enucleation had a smaller decrease in estimate glomerular filtration rate at 1 day (-7.88 vs -20.01%, p renal parenchyma volume preservation (89.19 vs 84.27%, p renal parenchyma volume preservation, warm ischemia time and baseline renal function were the important independent factors in determining long-term functional recovery. The laparoscopic radio frequency ablation assisted tumor enucleation technology has unique advantage and potential in preserving renal parenchyma without ischemia damage compared to conventional laparoscopic partial nephrectomy, and had a better outcome, thus we recommend this technique in selected T1a patients.

Creatinine Versus Cystatin C: Differing Estimates of Renal Function in Hospitalized Veterans Receiving Anticoagulants.

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Wang, Christina Hao; Rubinsky, Anna D; Minichiello, Tracy; Shlipak, Michael G; Price, Erika Leemann

2018-05-31

Current practice in anticoagulation dosing relies on kidney function estimated by serum creatinine using the Cockcroft-Gault equation. However, creatinine can be unreliable in patients with low or high muscle mass. Cystatin C provides an alternative estimation of glomerular filtration rate (eGFR) that is independent of muscle. We compared cystatin C-based eGFR (eGFR cys ) with multiple creatinine-based estimates of kidney function in hospitalized patients receiving anticoagulants, to assess for discordant results that could impact medication dosing. Retrospective chart review of hospitalized patients over 1 year who received non-vitamin K antagonist anticoagulation, and who had same-day measurements of cystatin C and creatinine. Seventy-five inpatient veterans (median age 68) at the San Francisco VA Medical Center (SFVAMC). We compared the median difference between eGFR by the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) study equation using cystatin C (eGFR cys ) and eGFRs using three creatinine-based equations: CKD-EPI (eGFR EPI ), Modified Diet in Renal Disease (eGFR MDRD ), and Cockcroft-Gault (eGFR CG ). We categorized patients into standard KDIGO kidney stages and into drug-dosing categories based on each creatinine equation and calculated proportions of patients reclassified across these categories based on cystatin C. Cystatin C predicted overall lower eGFR compared to creatinine-based equations, with a median difference of - 7.1 (IQR - 17.2, 2.6) mL/min/1.73 m 2 versus eGFR EPI , - 21.2 (IQR - 43.7, - 8.1) mL/min/1.73 m 2 versus eGFR MDRD , and - 25.9 (IQR - 46.8, - 8.7) mL/min/1.73 m 2 versus eGFR CG . Thirty-one to 52% of patients were reclassified into lower drug-dosing categories using cystatin C compared to creatinine-based estimates. We found substantial discordance in eGFR comparing cystatin C with creatinine in this group of anticoagulated inpatients. Our sample size was limited and included few women. Further

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

International Nuclear Information System (INIS)

Lufft, Volkmar; Fels, Lueder M.; Egbeyong-Baiyee, Daniel; Olbricht, Christoph J.; Hoogestraat-Lufft, Linda; Galanski, Michael

2002-01-01

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, μmol/l) and single-shot inulin clearance (In-Cl, ml/min) for the evaluation of renal function; and urine alpha 1-microglobuline (AMG, μg/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 μmol/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 that AP performed for RAS has

A simple and accurate grading system for orthoiodohippurate renal scans in the assessment of post-transplant renal function

International Nuclear Information System (INIS)

Zaki, S.K.; Bretan, P.N.; Go, R.T.; Rehm, P.K.; Streem, S.B.; Novick, A.C.

1990-01-01

Orthoiodohippurate renal scanning has proved to be a reliable, noninvasive method for the evaluation and followup of renal allograft function. However, a standardized system for grading renal function with this test is not available. We propose a simple grading system to distinguish the different functional phases of hippurate scanning in renal transplant recipients. This grading system was studied in 138 patients who were evaluated 1 week after renal transplantation. There was a significant correlation between the isotope renographic functional grade and clinical correlates of allograft function such as the serum creatinine level (p = 0.0001), blood urea nitrogen level (p = 0.0001), urine output (p = 0.005) and need for hemodialysis (p = 0.007). We recommend this grading system as a simple and accurate method to interpret orthoiodohippurate renal scans in the evaluation and followup of renal allograft recipients

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

DEFF Research Database (Denmark)

Kneifel, M; Scholze, A; Burkert, A

2006-01-01

It is important whether impairment of renal allograft function may deteriorate arterial stiffness in renal transplant recipients. In a cross-sectional study, arterial vascular characteristics were non-invasively determined in 48 patients with renal allograft using applanation tonometry and digital...

Effect of Shenkang injection combined with hemodialysis treatment on renal function, renal anemia and cytokine levels in patients with chronic renal failure

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Rui Liu

2016-10-01

Full Text Available Objective: To study the effect of Shenkang injection combined with hemodialysis treatment on renal function, renal anemia and cytokine levels in patients with chronic renal failure. Methods: A total of 68 patients with chronic renal failure who received hemodialysis treatment in our hospital during between October 2013 and February 2016 were selected and randomly divided into two groups, the observation group received Shenkang injection treatment in the process of dialysis, and the control group only received conventional symptomatic and supportive treatment. 8 weeks after treatment, serum was collected to determine the levels of renal function indexes, nutritional status indexes, anemia indexes and cytokines, and urine was collected to determine renal function indexes. Results: β2-MG, UA, Cr, phosphorus, IL-17, IL-23, CTGF, TGF-β1, FGF-2 and FGF-23 levels in serum as well as NGAL, KIM-1 and RBP levels in urine of observation group were significantly lower than those of control group, and TP, Alb, PA, calcium, Hb, EPO, Fe, TRF and FER levels in serum were significantly higher than those of control group. Conclusion: Shenkang injection combined with hemodialysis treatment helps to improve renal function, nutritional status and renal anemia, and reduce the synthesis of inflammation and renal interstitial fibrosis-related cytokines in patients with chronic renal failure.

Renal function study using I-123-OIH

International Nuclear Information System (INIS)

Yamashita, Masato; Osaka, Yosio; Aikawa, Ichiro

1989-01-01

Twenty-eight renal function studies were performed in 24 patients with renal diseases with I-123 orthoiodohippurate (I-123 OIH). Neither side effects nor abnormal laboratory values were attributable to I-123 OIH. Imaging with Tc-99m diethylene triaminepentaacetic acid (DTPA) was also performed in 20 patients within one week after I-123 imaging. Findings with I-123 OIH and Tc-99m DTPA were similar in all except for two patients. The two patients had received cadaveric renal transplantation. One patient presented with acute tubular necrosis and the other with chronic renal rejection. In these patients, I-123 imaging showed vascular stricture and Tc-99m imaging showed a decreased glomerular function. Because I-123 OIH and Tc-99m DTPA had different pharmacodynamics, combined use of the two imaging agents may be useful in evaluating renal rejection or acute tubular necrosis. (N.K.)

Dynamic renal scintigraphic estimation of deceased donor kidneys in a rat model

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Huseyin Aydin Mitil

2017-01-01

Full Text Available At present a large number of the renal transplantations are being performed from the deceased donors. The success of these transplantations depends on the viability of the deceased donor kidneys. The aim of this study was to investigate the reliability of scintigraphic estimation of function of deceased donor kidneys by comparing the histopathologic and scintigraphic findings. Ten rats were included in the study (2–3 months old, 250–300 g, all male. Control scintigraphy was performed to all the rats by injection of 37 MBq Tc-99m DTPA from the tail vein in a dynamic manner. Brain death of the rats was achieved by inflation of a Fogartys catheter in the cranial cavity. Immediately, after brain death confirmation, dynamic renal scintigraphy was performed with the same parameters of control scintigraphy. In the comparison of scintigraphies obtained in the before and just after brain death period, there was impairment of tubular functions, concentration and excretion functions in the postbrain death period. In the immediate postbrain death period, there was a significant elevation in the glomerular filtration rate and time to maximum concentration values. In the histopathological evaluation of the kidney samples in the postbrain death period, there were definitive findings of tubular impairment. Dynamic renal scintigraphy also demonstrated definite impairment of tubular system and tubular functions in the deceased donor kidneys. This could explain the reason of the increased frequency of acute tubular necrosis seen among deceased donor kidneys.

Renal function assessment in heart failure.

Science.gov (United States)

Pérez Calvo, J I; Josa Laorden, C; Giménez López, I

Renal function is one of the most consistent prognostic determinants in heart failure. The prognostic information it provides is independent of the ejection fraction and functional status. This article reviews the various renal function assessment measures, with special emphasis on the fact that the patient's clinical situation and response to the heart failure treatment should be considered for the correct interpretation of the results. Finally, we review the literature on the performance of tubular damage biomarkers. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Medicina Interna (SEMI). All rights reserved.

Clinical application of calculated split renal volume using computed tomography-based renal volumetry after partial nephrectomy: Correlation with technetium-99m dimercaptosuccinic acid renal scan data.

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Lee, Chan Ho; Park, Young Joo; Ku, Ja Yoon; Ha, Hong Koo

2017-06-01

To evaluate the clinical application of computed tomography-based measurement of renal cortical volume and split renal volume as a single tool to assess the anatomy and renal function in patients with renal tumors before and after partial nephrectomy, and to compare the findings with technetium-99m dimercaptosuccinic acid renal scan. The data of 51 patients with a unilateral renal tumor managed by partial nephrectomy were retrospectively analyzed. The renal cortical volume of tumor-bearing and contralateral kidneys was measured using ImageJ software. Split estimated glomerular filtration rate and split renal volume calculated using this renal cortical volume were compared with the split renal function measured with technetium-99m dimercaptosuccinic acid renal scan. A strong correlation between split renal function and split renal volume of the tumor-bearing kidney was observed before and after surgery (r = 0.89, P volumetry had a strong correlation with the split renal function measured using technetium-99m dimercaptosuccinic acid renal scan. Computed tomography-based split renal volume measurement before and after partial nephrectomy can be used as a single modality for anatomical and functional assessment of the tumor-bearing kidney. © 2017 The Japanese Urological Association.

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

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Peters, Brandilyn A; Hall, Megan N; Liu, Xinhua; Neugut, Y Dana; Pilsner, J Richard; Levy, Diane; Ilievski, Vesna; Slavkovich, Vesna; Islam, Tariqul; Factor-Litvak, Pam; Graziano, Joseph H; Gamble, Mary V

2014-01-01

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

Validation of a Functional Pyelocalyceal Renal Model for the Evaluation of Renal Calculi Passage While Riding a Roller Coaster.

Science.gov (United States)

Mitchell, Marc A; Wartinger, David D

2016-10-01

The identification and evaluation of activities capable of dislodging calyceal renal calculi require a patient surrogate or validated functional pyelocalyceal renal model. To evaluate roller coaster facilitation of calyceal renal calculi passage using a functional pyelocalyceal renal model. A previously described adult ureteroscopy and renoscopy simulator (Ideal Anatomic) was modified and remolded to function as a patient surrogate. Three renal calculi of different sizes from the patient who provided the original computed tomographic urograph on which the simulator was based were used. The renal calculi were suspended in urine in the model and taken for 20 rides on the Big Thunder Mountain Railroad roller coaster at Walt Disney World in Orlando, Florida. The roller coaster rides were analyzed using variables of renal calculi volume, calyceal location, model position on the roller coaster, and renal calculi passage. Sixty renal calculi rides were analyzed. Independent of renal calculi volume and calyceal location, front seating on the roller coaster resulted in a passage rate of 4 of 24. Independent of renal calculi volume and calyceal location, rear seating on the roller coaster resulted in a passage rate of 23 of 36. Independent of renal calculi volume in rear seating, calyceal location differed in passage rates, with an upper calyceal calculi passage rate of 100%; a middle calyceal passage rate of 55.6%; and a lower calyceal passage rate of 40.0%. The functional pyelocalyceal renal model serves as a functional patient surrogate to evaluate activities that facilitate calyceal renal calculi passage. The rear seating position on the roller coaster led to the most renal calculi passages.

Vesicoureteral refluxed volume and renal function

International Nuclear Information System (INIS)

Markovic, V.; Capkun, V.; Eterovic, D.; Stanicic, A.; Saraga, M.

1994-01-01

The therapeutical approach to vesicoureteral reflux (VUR) depends on assessment of the renal involvement. The effective renal plasma flow (ERPF) and parenchymal mean transit time of radiotracer (pMTT) of the affected kidney are sensitive functional parameters. We investigated the association of these functional indices with the volume of refluxed urine. In 64 children (mean age 6.4 yrs) the presence of VUR was confirmed with direct radionuclide cystography in 80 ureters (48 unilateral and 32 bilateral) and the maximal volume of refluxed urine (MVRU) was determined for each uretero-renal unit. All patients also underwent dynamic renal scintigraphy with I-131-hippuran, providing the values of pMTT and relative renal hippuran clearances of the respective kidneys by deconvolution analysis. In 37 of the affected kidneys ERPF was also determined by combining the latter results with total ERPF, determined by plasma clearance of hippuran. Using the borderline value of MVRU of 4 ml, the group with higher MVRU exhibited significantly lower ERPF of the affected kidney (194±93 vs. 270±77 ml/min/1.73 m2, p=.002) and significantly higher proportion of pMTT's over 3.5 min (31/33 vs. 17/47, p=.003). The negative linear correlation between MVRU and ERPF was found (r=-.45, p=.006). We conclude that quantitative radionuclide cystography, aside from diagnosis and follow-up of VUR, may also provide insight in the function of the affected kidney and thus contribute in designing the therapeutical approach. (author)

Using OCT to predict post-transplant renal function

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Andrews, Peter M.; Chen, Yu; Wierwille, Jeremiah; Joh, Daniel; Alexandrov, Peter; Rogalsky, Derek; Moody, Patrick; Chen, Allen; Cooper, Matthew; Verbesey, Jennifer E.; Gong, Wei; Wang, Hsing-Wen

2013-03-01

The treatment of choice for patients with end-stage renal disease is kidney transplantation. However, acute tubular necrosis (ATN) induced by an ischemic insult (e.g., from prolonged ex vivo storage times, or non-heart beating cadavers) is a major factor limiting the availability of donor kidneys. In addition, ischemic induced ATN is a significant risk factor for eventual graft survival and can be difficult to discern from rejection. Currently, there are no rapid and reliable tests to determine ATN suffered by donor kidneys and whether or not donor kidneys might exhibit delayed graft function. OCT (optical coherence tomography) is a rapidly emerging imaging modality that can function as a type of "optical biopsy", providing cross-sectional images of tissue morphology in situ and in real-time. In a series of recent clinical trials, we evaluated the ability of OCT to image those features of the renal microstructure that are predictive of ATN. Specifically, we found that OCT could effectively image through the intact human renal capsule and determine the extent of acute tubular necrosis. We also found that Doppler based OCT (i.e., DOCT) revealed renal blood flow dynamics that is also reported to be a determiner of post-transplant renal function. This kind of information will allow transplant surgeons to make the most efficient use of available donor kidneys, eliminate the possible use of bad donor kidneys, provide a measure of expected post-transplant renal function, and allow better distinction between post-transplant immunological rejection and ischemic-induced acute renal failure.

Interaction of cis-diamminedichloroplatinum and renal irradiation on renal function in the young and adult rat

International Nuclear Information System (INIS)

Jongejan, H.T.M.; Provoost, A.P.; Molenaar, J.C.

1987-01-01

In the present study the age-dependence has been investigated of renal injury following the combined administration of c-DDP and irradiation. Single doses of c-DDP and radiation, causing a limited renal function decline on their own, were applied in combination. Following treatment, renal function and systolic blood pressure (SBP) were measured for 6 months. 25 refs.; 3 figs.; 2 tabs

Radiation tolerance of the pig kidney: a model for determining overall time and fraction factors for preserving renal function

International Nuclear Information System (INIS)

Hopewell, J.W.

1975-01-01

The Ellis Nominal Standard Dose system has attracted clinical interest for estimating irregular treatment schedules in radiotherapy. This study attempts to examine the system applied to renal tolerance in swine by looking for some regular relationship between time, dose, and fractionation. Also examined was renal function up to two years after treatment. These data indicate that renal tolerance may not be predictable by any simple mathematical expression

Magnetic resonance in the assessment of renal function

International Nuclear Information System (INIS)

Knesplova, L.; Krestin, G.P.

1998-01-01

The kidneys are the most important organs to maintain homeostasis. In the assessment of renal functional disorders laboratory tests offer only indirect hints on location of the disease; radionuclide nephrography is hampered by low spatial resolution and radiologic methods provide only limited quantitative information. The MRI technique with fast pulse sequences and renally eliminated contrast agent has the capability of combining both anatomic and functional information. This article gives an overview on functional MRI of the kidneys with its possibilities and limitations. The clinical application of functional MRI allows a better understanding of some pathologic conditions such as urinary tract obstruction, renal insufficiency, effects of extracorporeal shock wave lithotripsy, different states of hydration, effects of drugs, vascular disorders, and effects of transplantation. (orig.)

Significant association between renal function and amyloid-positive area in renal biopsy specimens in AL amyloidosis

Directory of Open Access Journals (Sweden)

Kuroda Takeshi

2012-09-01

Full Text Available Abstract Background The kidney is a major target organ for systemic amyloidosis that often affects the kidney including proteinura, and elevated serum creatinine (Cr. The correlation between amount of amyloid deposits and clinical parameters is not known. The aim of this study was to clarify correlation the amyloid area in all renal biopsy specimen and clinical parameters. Methods Fifty-eight patients with an established diagnosis of AL amyloidosis participated in the study. All patients showed amyloid deposits in renal biopsies. We retrospectively investigated the correlation between clinical data and amyloid occupied area in whole renal biopsy specimens. Results The area occupied by amyloid was less than 10% in 57 of the 58 patients, and was under 2% in 40. For statistical analyses, %amyloid-positive areas were transformed to common logarithmic values (Log10%amyloid. Cr showed significant correlation with Log10%amyloid and estimated glomerular filtration rate (eGFR showed the significant negative correlation. Patient age, cleatinine clearance (Ccr, blood urea nitorogen, and urinary protein was not significantly correlated with Log10%amyloid. The correlation with other clinical factors such as sex, and serum concentrations of total protein, albumin, immunoglobulins, compliments was evaluated. None of these factors significantly correlated with Log10%amyloid. According to sex- and age- adjusted multiple linear regression analysis, Log10%amyloid had significant positive association with Cr and significant negative association with eGFR. Conclusion There is significant association between amyloid-positive area in renal tissue and renal function, especially Cr and eGFR. The level of Cr and eGFR may be a marker of amount of amyloid in renal tissue.

Radionuclide dynamic renal imaging for renal function study in patients with NIDDM

International Nuclear Information System (INIS)

Yang Ruiping; Qu Wanying; Gao Wenping

1996-01-01

Radionuclide dynamic renal imaging was performed to gain evidence for further treatment and evaluation of prognosis in patients with non-insulin-dependent diabetes mellitus (NIDDM). 99m Tc-DTPA dynamic renal imaging was performed in 137 NIDDM patients and 44 normal controls (NC). Glomerular filtration rate (GFR) and renogram were acquired simultaneously. Renal tubular secretion function was measured with 99m Tc-EC in 126 of the 137 diabetics and 17 NC. GFR decreased in all patients with different duration of NIDDM and the difference was remarkably significance in comparison with NC (t = 7.17∼13.73, P 99m Tc-EC. This study showed that the function of glomerular filtration and tubular secretion were both damaged in all diabetics. Their magnitude was aggravated with the prolongation of the course of disease

Aortic Blood Flow Reversal Determines Renal Function: Potential Explanation for Renal Dysfunction Caused by Aortic Stiffening in Hypertension.

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Hashimoto, Junichiro; Ito, Sadayoshi

2015-07-01

Aortic stiffness determines the glomerular filtration rate (GFR) and predicts the progressive decline of the GFR. However, the underlying pathophysiological mechanism remains obscure. Recent evidence has shown a close link between aortic stiffness and the bidirectional (systolic forward and early diastolic reverse) flow characteristics. We hypothesized that the aortic stiffening-induced renal dysfunction is attributable to altered central flow dynamics. In 222 patients with hypertension, Doppler velocity waveforms were recorded at the proximal descending aorta to calculate the reverse/forward flow ratio. Tonometric waveforms were recorded to measure the carotid-femoral (aortic) and carotid-radial (peripheral) pulse wave velocities, to estimate the aortic pressure from the radial waveforms, and to compute the aortic characteristic impedance. In addition, renal hemodynamics was evaluated by duplex ultrasound. The estimated GFR was inversely correlated with the aortic pulse wave velocity, reverse/forward flow ratio, pulse pressure, and characteristic impedance, whereas it was not correlated with the peripheral pulse wave velocity or mean arterial pressure. The association between aortic pulse wave velocity and estimated GFR was independent of age, diabetes mellitus, hypercholesterolemia, and antihypertensive medication. However, further adjustment for the aortic reverse/forward flow ratio and pulse pressure substantially weakened this association, and instead, the reverse/forward flow ratio emerged as the strongest determinant of estimated GFR (P=0.001). A higher aortic reverse/forward flow ratio was also associated with lower intrarenal forward flow velocities. These results suggest that an increase in aortic flow reversal (ie, retrograde flow from the descending thoracic aorta toward the aortic arch), caused by aortic stiffening and impedance mismatch, reduces antegrade flow into the kidney and thereby deteriorates renal function. © 2015 American Heart Association

The influence of partial renal function impairment on thyroid hormones level in acute renal failure-ARF patients

International Nuclear Information System (INIS)

Ilic, S.; Vlajkovic, M.; Rajic, M.; Bogicevic, M.

2002-01-01

The aim of this study was to assess the relationship of thyroid hormone levels with glomerular and tubular renal function in ARF. In thirty one patients with different underlying diseases, glomerular filtration (GFR) was estimated by measuring 99mTc-DTPA clearance and tubular function by 131I-OIH clearance. The thyroid status was evaluated by radioimmunoassays of T4, FT4, T3, FT3, rT3 and TSH, while the cortisol level was used to indicate the stress role. All the measurements were performed within 7 days as well after 1,3,6 and 12 months from the ARF onset. The results obtained were compared with those of 30 healthy subjects. At the ARF beginning, the impairment of renal function was manifested by the fall of 99mTc-DTPA clearance to 21∫7ml/min and 131I-OIH clearance to 172±34ml/min, while end values were 77±19ml/min and 395±70ml/min, respectively. The hormone analysis within 7 days, showed T3 decrease to 1.21±0.16nmol/l and the increase rT3 to 38±7ng/1ooml, as well as cortisol to 350±71ng/ml, but at the end of the study these hormone levels were normalized. Other hormone levels didn't differ significantly from control values. Regression analysis established significant correlation of 99mTc-DTPA clearance with T3 (r=0.693, p 100, OIH>500), partial recovery (DTPA 51-100, OIH 250-500) and without any recovery (DTPA<50,OIH<250), showed hormone disturbances proportional to the degree of renal function damage. The most severe disorders were found in the third group, where both total and free T4 and T3 were lowered, while rT3 and cortisol elevated at 7th day from ARF onset. After 12 months all these values associated with that of TSH were observed as declined.This study suggests thyroid hormone levels to be dependent on the renal function in ARF. Greater impairment of glomerular related to tubular function appears to be more responsible for thyroid dysfunction, due to uremic toxins retention as well as stress induced by the extreme function failure

[Decline in renal function in old age : Part of physiological aging versus age-related disease].

Science.gov (United States)

Braun, F; Brinkkötter, P T

2016-08-01

The incidence and prevalence of chronic renal disease (CKD) in elderly patients are continuously increasing worldwide. Loss of renal function is not only considered to be part of the aging process itself but also reflects the multimorbidity of many geriatric patients. Calculating the glomerular filtration rate using specific algorithms validated for the elderly population and measuring the amount of proteinuria allow an estimation of renal function in elderly patients with high accuracy. Chronic renal failure has many clinical consequences and not only results in a delayed excretion of toxins cleared by the kidneys but also affects hematogenesis, water and electrolyte balance as well as mineral bone metabolism. Furthermore, CKD directly leads to and aggravates geriatric syndromes and in particular the onset of frailty. Therapeutic strategies to halt progression of CKD not only comprise treatment of the underlying disease but also efficient blood pressure and diabetic control and the avoidance of nephrotoxic medications.

Renal function improves with the treatment of hypothyroidism.

Science.gov (United States)

Bulur, Oktay; Dal, Kursat; Ertugrul, Derun Taner; Eser, Murat; Kaplan Efe, Fatma; Karakaya, Serdar; Şahin, Kubilay; Baser, Salih; Ata, Naim; Aybal Kutlugun, Aysun; Beyan, Esin

2017-08-01

It has been known that thyroid hormones may affect renal function. In this study, we aimed to investigate the effect of levothyroxine replacement on renal function in hypothyroid patients before and after treatment. We retrospectively investigated free T3 (fT3), free T4 (fT4), TSH, creatinine, and eGFR measurements during both hypothyroid and euthyroid states of hypothyroid patients. The eGFR was calculated using the simplified Modification of Diet in Renal Disease formula. fT3, fT4, and eGFR measurements increased, meanwhile creatinine and TSH levels decreased significantly after euthyroidism was achieved with levothyroxine treatment (p treatment (r: 0.288, p treatment (r: -0.272, p hypothyroidism and found out that renal function improved in most patients after euthyroidism was achieved. In some patients, above-normal creatinine levels completely returned to normal once the patients became euthyroid.

Serial radionuclide quantitative function studies for evaluation of renal transplants

International Nuclear Information System (INIS)

Martin, D.C.; Hunter, J.L.; Lawton, M.B.; Berke, R.A.; Morton, M.E.

1974-01-01

A new method of assessing renal function following transplantation has been presented. The calculated rate of transfer to the kidney expressed as percent per minute, effective renal blood flow in milliliters per minute and the percentage of the dose in the urine at 20 minutes are calculated from data derived from a scintillation probe over the heart following a single injection of radiohippuran. These indices provide a means of interpreting serial determinations of renal function in states in which the more conventional parameters of renal function are not reliable. (U.S.)

Clinical use of estimated glomerular filtration rate for evaluation of kidney function

DEFF Research Database (Denmark)

Broberg, Bo; Lindhardt, Morten; Rossing, Peter

2013-01-01

is a significant predictor for cardiovascular disease and may along with classical cardiovascular risk factors add useful information to risk estimation. Several cautions need to be taken into account, e.g. rapid changes in kidney function, dialysis, high age, obesity, underweight and diverging and unanticipated......Estimating glomerular filtration rate by the Modification of Diet in Renal Disease or Chronic Kidney Disease Epidemiology Collaboration formulas gives a reasonable estimate of kidney function for e.g. classification of chronic kidney disease. Additionally the estimated glomerular filtration rate...

Radionuclide determination of individual kidney function in the treatment of chronic renal obstruction

International Nuclear Information System (INIS)

Belis, J.A.; Belis, T.E.; Lai, J.C.; Goodwin, C.A.; Gabriele, O.F.

1982-01-01

Differential radionuclide renal scans can be useful in the management of patients with chronic partial obstruction of 1 kidney. The /sup 99m/Tc diethylenetriaminepentaacetic acid perfusion scan can be used to assess glomerular blood flow. The 131 I orthoiodohippurate renal scan provides qualitative functional information from scintigrams and quantitative evaluation of effective renal plasma flow to each kidney, as well as a total excretory index. Sequential /sup 99m/Tc diethylenetriaminepentaacetic acid and 131 I orthoiodohippurate renal scans were used to assess individual renal function before and after surgical correction of unilateral chronic renal obstruction in 31 patients. The preservation of cortical perfusion on /supb 99m/Tc diethylenetriaminepentaacetic acid scans indicated that potential existed for partial recovery of renal function. Effective renal plasma flow and excretory index determined in conjunction with the 131 I orthoiodohippurate scans provided a quantitative assessment of preoperative renal function, an evaluation of the effect of surgery and a sensitive method for long-term evaluation of differential renal function. Correction of ureteropelvic junction obstruction usually resulted in improvement in unilateral renal function. Neither nephrolithotomy nor extended pyelolithotomy diminished renal function in the kidney subjected to an operation and often improved it. Patients with long-standing distal ureteral obstruction had the least improvement in renal function postoperatively

Overvalue relative renal function in unilateral ureteropelvic junction obstruction?

International Nuclear Information System (INIS)

Baquedano, P.; Orellana, P.; Varas, J.

2002-01-01

Introduction: Relative renal function (RRF) is used as an important parameter in the surgical decision of hydronephrosis. In addition, the presence of a supranormal RRF (RRF > 55%) in the hydronephrotic kidney had been recognized. However, this over estimation is, in our experience, not only present with a RRF over 55%. We evaluated demographic data, ultrasonographic finding, age of surgery, presentation (antenatal diagnosis vs postnatal clinical symptoms) in children with unilateral hydronephrosis and a RRF which decreased after surgery. Materials and Methods: Of a series of 66 patients with unilateral ureteropyelic junction obstruction (UPJ) obstruction consecutively operated and followed in the Pediatric Urology unit of Catholic University of Chile, we analyzed 8 cases (12%) in which the relative renal function quantified by diuretic renography with Tc99 MAG3 decreased during follow-up after surgery, over 10% of the baseline value; 6 to 12 months post pyeloplasty, 7 boys, 6 cases with UPJ obstruction of the left side. 3 cases were diagnosed by prenatal ultrasound, 1 by abdominal mass, 1 by urinary tract infection, 1 by abdominal pain and 2 by screening. The age at the time of the surgery was in 4 cases 1 month of life, in two children between 6 and 12 months of age, one boy was 2.4 year old and another one was 7.3 year old. All were considered as a severe hydronefrosis in the ultrasound and 4 cases had a severe atrophy of renal parenchyma. The initial RRF of these cases varied from 35% to 62%. In half of the cases the initial RRF was considered normal, in 2 cases was abnormal ( 55%). In all of these children the RRF decreased after surgery in an average of 35% (28%-54%) of the initial RRF, none of these patients had a normal RRF after surgery. There was no differences in clinical presentation and radiological findings among them. However, it is worth to mention that the symptomatic presentation (pain, abdominal mass) was more frequent in this group that in our

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.

Magnetic resonance in the assessment of renal function

Energy Technology Data Exchange (ETDEWEB)

Knesplova, L.; Krestin, G.P. [Department of Radiology, University Hospital Zurich (Switzerland)

1998-03-01

The kidneys are the most important organs to maintain homeostasis. In the assessment of renal functional disorders laboratory tests offer only indirect hints on location of the disease; radionuclide nephrography is hampered by low spatial resolution and radiologic methods provide only limited quantitative information. The MRI technique with fast pulse sequences and renally eliminated contrast agent has the capability of combining both anatomic and functional information. This article gives an overview on functional MRI of the kidneys with its possibilities and limitations. The clinical application of functional MRI allows a better understanding of some pathologic conditions such as urinary tract obstruction, renal insufficiency, effects of extracorporeal shock wave lithotripsy, different states of hydration, effects of drugs, vascular disorders, and effects of transplantation. (orig.) With 9 figs., 62 refs.

Blood transfusion improves renal oxygenation and renal function in sepsis-induced acute kidney injury in rats

NARCIS (Netherlands)

L. Zafrani (Lara); B. Ergin (Bulent); Kapucu, A. (Aysegul); C. Ince (Can)

2016-01-01

textabstractBackground: The effects of blood transfusion on renal microcirculation during sepsis are unknown. This study aimed to investigate the effect of blood transfusion on renal microvascular oxygenation and renal function during sepsis-induced acute kidney injury. Methods: Twenty-seven Wistar

Evaluation of recovery in hydronephrosis using renal functional CT studies

International Nuclear Information System (INIS)

Watanabe, Kiyotaka

1985-01-01

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

Blood transfusion improves renal oxygenation and renal function in sepsis-induced acute kidney injury in rats

NARCIS (Netherlands)

Zafrani, Lara; Ergin, Bulent; Kapucu, Aysegul; Ince, Can

2016-01-01

The effects of blood transfusion on renal microcirculation during sepsis are unknown. This study aimed to investigate the effect of blood transfusion on renal microvascular oxygenation and renal function during sepsis-induced acute kidney injury. Twenty-seven Wistar albino rats were randomized into

Blood transfusion improves renal oxygenation and renal function in sepsis-induced acute kidney injury in rats.

Science.gov (United States)

Zafrani, Lara; Ergin, Bulent; Kapucu, Aysegul; Ince, Can

2016-12-20

The effects of blood transfusion on renal microcirculation during sepsis are unknown. This study aimed to investigate the effect of blood transfusion on renal microvascular oxygenation and renal function during sepsis-induced acute kidney injury. Twenty-seven Wistar albino rats were randomized into four groups: a sham group (n = 6), a lipopolysaccharide (LPS) group (n = 7), a LPS group that received fluid resuscitation (n = 7), and a LPS group that received blood transfusion (n = 7). The mean arterial blood pressure, renal blood flow, and renal microvascular oxygenation within the kidney cortex were recorded. Acute kidney injury was assessed using the serum creatinine levels, metabolic cost, and histopathological lesions. Nitrosative stress (expression of endothelial (eNOS) and inducible nitric oxide synthase (iNOS)) within the kidney was assessed by immunohistochemistry. Hemoglobin levels, pH, serum lactate levels, and liver enzymes were measured. Fluid resuscitation and blood transfusion both significantly improved the mean arterial pressure and renal blood flow after LPS infusion. Renal microvascular oxygenation, serum creatinine levels, and tubular damage significantly improved in the LPS group that received blood transfusion compared to the group that received fluids. Moreover, the renal expression of eNOS was markedly suppressed under endotoxin challenge. Blood transfusion, but not fluid resuscitation, was able to restore the renal expression of eNOS. However, there were no significant differences in lactic acidosis or liver function between the two groups. Blood transfusion significantly improved renal function in endotoxemic rats. The specific beneficial effect of blood transfusion on the kidney could have been mediated in part by the improvements in renal microvascular oxygenation and sepsis-induced endothelial dysfunction via the restoration of eNOS expression within the kidney.

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

Directory of Open Access Journals (Sweden)

Itay Shafat

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

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

Energy Technology Data Exchange (ETDEWEB)

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

2009-02-15

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

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

International Nuclear Information System (INIS)

Urbania, Thomas H.; Kammen, Bamidele F.; Nancarrow, Paul A.; Morrell, Rose Ellen

2009-01-01

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

Classification of tubulo-papillary renal cortical tumours using estimates of nuclear volume

DEFF Research Database (Denmark)

Brooks, B; Sørensen, Flemming Brandt; Olsen, S

1993-01-01

The classification of renal cortical tumours is problematic, with no clear division of benign from malignant tumours. Unbiased stereological estimates of volume-weighted nuclear volume (nuclear vv) were obtained by point sampling of nuclear intercepts in a retrospective study of 36 variably sized...... = 241 microns 3) and 15 tumours classified as renal cell carcinomas with diameters > 3 cm, or aggressive histological pattern (average nuclear vv = 229 microns 3) (2p = 0.68). In this subtype of renal cortical tumours, estimates of nuclear vv do not support the historical convention of using a 3 cm...... tumour diameter as the dividing line between adenomas and carcinomas, but support the theory of a single group of tumours. As most of the truly incidental renal cortical tumours are less than 1 cm in diameter, this limit could be considered. Such small benign cortical nodules have never been reported...

Correction of differential renal function for asymmetric renal area ratio in unilateral hydronephrosis.

Science.gov (United States)

Aktaş, Gul Ege; Sarıkaya, Ali

2015-11-01

Children with unilateral hydronephrosis are followed up with anteroposterior pelvic diameter (APD), hydronephrosis grade, mercaptoacetyltriglycine (MAG-3) drainage pattern and differential renal function (DRF). Indeterminate drainage preserved DRF in higher grades of hydronephrosis, in some situations, complicating the decision-making process. Due to an asymmetric renal area ratio, falsely negative DRF estimations can result in missed optimal surgery times. This study was designed to assess whether correcting the DRF estimation according to kidney area could reflect the clinical situation of a hydronephrotic kidney better than a classical DRF calculation, concurrently with the hydronephrosis grade, APD and MAG-3 drainage pattern. We reviewed the MAG-3, dimercaptosuccinic acid (DMSA) scans and ultrasonography (US) of 23 children (6 girls, 17 boys, mean age: 29 ± 50 months) with unilateral hydronephrosis. MAG-3 and DMSA scans were performed within 3 months (mean 25.4 ± 30.7 days). The closest US findings (mean 41.5 ± 28.2 days) were used. DMSA DRF estimations were obtained using the geometric mean method. Secondary calculations were performed to correct the counts (the total counts divided by the number of pixels in ROI) according to kidney area. The renogram patterns of patients were evaluated and separated into subgroups. The visual assessment of DMSA scans was noted and the hydronephrotic kidney was classified in comparison to the normal contralateral kidney's uptake. The correlations of the DRF values of classical and area-corrected methods with MAG-3 renogram patterns, the visual classification of DMSA scan, the hydronephrosis grade and the APD were assessed. DRF estimations of two methods were statistically different (p: 0.001). The categories of 12 hydronephrotic kidneys were changed. There were no correlations between classical DRF estimations and the hydronephrosis grade, APD, visual classification of the DMSA scan and uptake evaluation. The DRF

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

Science.gov (United States)

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

2012-01-01

The P wave parameters measured by 12-lead electrocardiogram (ECG) are commonly used as noninvasive tools to assess for left atrial enlargement. There are limited studies to evaluate whether P wave parameters are independently associated with decline in renal function. Accordingly, the aim of this study is to assess whether P wave parameters are independently associated with progression to renal end point of ≥25% decline in estimated glomerular filtration rate (eGFR). This longitudinal study included 166 patients. The renal end point was defined as ≥25% decline in eGFR. We measured two ECG P wave parameters corrected by heart rate, i.e. corrected P wave dispersion (PWdisperC) and corrected P wave maximum duration (PWdurMaxC). Heart function and structure were measured from echocardiography. Clinical data, P wave parameters, and echocardiographic measurements were compared and analyzed. Forty-three patients (25.9%) reached renal end point. Kaplan-Meier curves for renal end point-free survival showed PWdisperC > median (63.0 ms) (log-rank P = 0.004) and PWdurMaxC > median (117.9 ms) (log-rank Pfunction decline.

The 64-MSCT study of relationship between renal corticomedullary differentiation, contrast between renal cortex and medulla, renal cortex and medulla CT peak value with the single renal function in hydronephrotic kidney

International Nuclear Information System (INIS)

Wang Yunhua; Hou Weiwei; Liu Ruihong; He Jianjun; Zhi Ke

2009-01-01

Objective: To study 64-MSCT perfusion imaging features about renal corticomedullary differentiation, contrast between renal cortex and medulla (CMC), renal cortex and medulla CT peak value in normal and hydronephrotic kidneys, and to explore the relationship between them and the unilateral renal function. Methods: Thirty-six patients with obstructive nephrohydrosis underwent 64-MSCT perfusion scanning. The split renal glomerular filtration rates (GFR) of their kidneys were measured by SPECT renal dynamic imaging. The 72 kidneys were divided into groups of normal renal function group, mild and severe renal impairment groups according to GFR. Renal corticomedullary differentiation on CT images was graded as clear, obscure, part clear. The CT intensity of cortex and medulla was measured in order to calculate contrast between renal cortex and medulla (CMC). Using Pearson correlation test, the correlation between them and renal GFR were examined. Results: (1) In the 24 kidneys of normal group, all kidneys showed clear CMD. In the 21 kidneys of mild renal impairment group, 14 kidneys showed clear CMD, 2 showed obscure CMD and 5 showed part clear of CMD. In the 27 kidneys of severe renal impairment group, 7 kidneys showed clear CMD, 5 showed obscure CMD and 15 showed part clear of CMD. (2)The CMC of normal group was 0.62 ± 0.20, while it was 0.52 ± 0.14 and 0.37 ± 0.11 for mild renal impairment group and severe renal impairment group CMC respectively. The CMC had positive linear correlation with GFR (r=0.536,P<0.05). (3) The renal cortex and medulla CT peak value of normal group were (133 ± 22) and (104 ± 16) HU; The renal cortex and medulla CT peak value of mild renal impairment group were (91 ± 29) and (76 ± 25) HU; The renal cortex and medulla CT peak value of severe renal impairment group were (68 ± 24) and (57 ± 21) HU(F=42.76 and 32.68,P<0.05). The renal cortex and medulla CT peak value had positive linear correlation with GFR (r=0.672 and 0.623, P<0

Monitoring renal function during biphosphonate treatment in patients with bone metastases - role of dynamic kidney scintigraphy

International Nuclear Information System (INIS)

Chavdarova, L.; Tzonevska, A.

2015-01-01

Full text: Biphosphonates (BP) are very effective in treatment of bone metastatic disease. Their renal excretion defines one of the major side effects - nephrotoxicity. Glomerular filtration rate (GFR) is a basic parameter for its early detection but clinical practice often uses only serum creatinine. Aim of our retrospective study is to assess the role of dynamic kidney scintigraphy (DKS) and the estimated during it GFR in BP-treated patients with bone metastatic disease. 61 patients (53 female, 8 male), aged 33-82, with biphosphonate-treated bone metastases from breast (n53), lung (n1) and prostate (n7) cancer were enrolled for the period 27.04.2012-14.04.2015. Overall 77 studies were made, in 13 patients more than one. GFR was assessed in 57 studies. Results were compared with serum creatinine. All patients with elevated creatinine showed low GFR and decreased renal function at DKS. With normal creatinine and decreased GFR: in 31 studies kidney function was reduced, in 14 function was normal but kidney scintigraphic appearance was disturbed- mostly as in diffuse parenchymal disease. In 5 studies GFR was normal and renal function decreased. In 3 studies both parameters were normal. Zoledronic acid was changed with denosumab in 2 patients because of worsened function and strongly reduced GFR, in one patient BP was stopped after DKS. In 3 patients the interval between BP was extended because of affected renal function. GFR is more sensitive than serum creatinine levels and changes in nephrographic curves. Dynamic kidney scintigraphy is a functional method directing clinical reaction to preserve renal function

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

International Nuclear Information System (INIS)

Rutland, M.D.; Hassan, I.M.; Que, L.

1999-01-01

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

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

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Fernando G. Abarzua-Cabezas

2015-02-01

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

Effect of Cuscuta chinensis on renal function in ischemia/reperfusion-induced acute renal failure rats.

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Shin, Sun; Lee, Yun Jung; Kim, Eun Ju; Lee, An Sook; Kang, Dae Gill; Lee, Ho Sub

2011-01-01

The kidneys play a central role in regulating water, ion composition and excretion of metabolic waste products in the urine. Cuscuta chinensis has been known as an important traditional Oriental medicine for the treatment of liver and kidney disorders. Thus, we studied whether an aqueous extract of Cuscuta chinensis (ACC) seeds has an effect on renal function parameters in ischemia/reperfusion-induced acute renal failure (ARF) rats. Administration of 250 mg/kg/day ACC showed that renal functional parameters including urinary excretion rate, osmolality, Na(+), K(+), Cl(-), creatinine clearance, solute-free water reabsorption were significantly recovered in ischemia/reperfusion-induced ARF. Periodic acid Schiff staining showed that administration of ACC improved tubular damage in ischemia/reperfusion-induced ARF. In immunoblot and immunohistological examinations, ischemia/reperfusion-induced ARF decreased the expressions of water channel AQP 2, 3 and sodium potassium pump Na,K-ATPase in the renal medulla. However, administration of ACC markedly incremented AQP 2, 3 and Na,K-ATPase expressions. Therefore, these data indicate that administration of ACC ameliorates regulation of the urine concentration and renal functions in rats with ischemia/reperfusion-induced ARF.

EXPERIMENTAL AND CLINICAL SIGNIFICANCE OF RENAL FUNCTIONAL RESERVE DETERMINATION

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Jernej Pajek

2002-07-01

Full Text Available Background. Renal functional reserve (RFR is defined as the temporary increase in glomerular filtration rate (GFR which follows the ingestion of proteins or infusion of aminoacids. This renal vasodilatatory response is probably mediated by several mechanisms, with nitric oxide being one of the most important mediators. In the last years significant progress in measuring renal functional reserve has been achieved on the basis of improvements in methods for accurate and timely appropriate GFR measurement. The method of GFR measurement using the sinistrin clearence calculation after bolus injection of sinistrin is increasingly employed.Conclusions. The article presents the latest results of experiments with RFR using this method and compares them with older reports. RFR is affected by several patophysiological processes: arterial hypertension, diabetes mellitus, deteriorating function of transplanted kidney. The results and impact of RFR determination in this conditions are described. Finally, potential for further research of RFR in atherosclerotic vascular disease is considered. Accurate determination of RFR is important for detection of early renal hemodynamic abnormalities, which can be influenced by therapeutic interventions and in this way the progression of renal functional deterioration could be prevented or at least slowed.

Reversal deterioration of renal function accompanied with primary hypothyrodism.

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Dragović, Tamara

2012-02-01

Hypothyroidism is often accompanied with decline of kidney function, or inability to maintain electrolyte balance. These changes are usually overlooked in everyday practice. Early recognition of this association eliminates unnecessary diagnostic procedures that postpone the adequate treatment. Two patients with elevated serum creatinine levels due to primary autoimmune hypothyroidism, with complete recovery of creatinine clearance after thyroid hormone substitution therapy are presented. The first patient was a young male whose laboratory tests suggested acute renal failure, and the delicate clinical presentation of reduced thyroid function. The second patient was an elderly woman with a history of a long-term signs and symptoms attributed to ageing, including the deterioration of renal function, with consequently delayed diagnosis of hypothyroidism. Serum thyrotropin and thyroxin levels measurement should be done in all cases of renal failure with undefined renal desease, even if the typical clinical presentation of hypothyroidism is absent. Thyroid hormone assays sholud also be performed in all patients with chronic kidney disease whose kidney function is rapidly worsening.

GPER Mediates Functional Endothelial Aging in Renal Arteries.

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Meyer, Matthias R; Rosemann, Thomas; Barton, Matthias; Prossnitz, Eric R

2017-01-01

Aging is associated with impaired renal artery function, which is partly characterized by arterial stiffening and a reduced vasodilatory capacity due to excessive generation of reactive oxygen species by NADPH oxidases (Nox). The abundance and activity of Nox depends on basal activity of the heptahelical transmembrane receptor GPER; however, whether GPER contributes to age-dependent functional changes in renal arteries is unknown. This study investigated the effect of aging and Nox activity on renal artery tone in wild-type and GPER-deficient (Gper-/-) mice (4 and 24 months old). In wild-type mice, aging markedly impaired endothelium-dependent, nitric oxide (NO)-mediated relaxations to acetylcholine, which were largely preserved in renal arteries of aged Gper-/- mice. The Nox inhibitor gp91ds-tat abolished this difference by greatly enhancing relaxations in wild-type mice, while having no effect in Gper-/- mice. Contractions to angiotensin II and phenylephrine in wild-type mice were partly sensitive to gp91ds-tat but unaffected by aging. Again, deletion of GPER abolished effects of Nox inhibition on contractile responses. In conclusion, basal activity of GPER is required for the age-dependent impairment of endothelium-dependent, NO-mediated relaxation in the renal artery. Restoration of relaxation by a Nox inhibitor in aged wild-type but not Gper-/- mice strongly supports a role for Nox-derived reactive oxygen species as the underlying cause. Pharmacological blockers of GPER signaling may thus be suitable to inhibit functional endothelial aging of renal arteries by reducing Nox-derived oxidative stress and, possibly, the associated age-dependent deterioration of kidney function. © 2017 S. Karger AG, Basel.

Functional genomics in renal transplantation and chronic kidney disease

International Nuclear Information System (INIS)

Wilflingseder, J.

2010-01-01

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

Serum uric acid and renal function in patients with type 1 diabetes: a nationwide study in Brazil.

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Pizarro, Marcela Haas; Santos, Deborah Conte; Barros, Bianca Senger Vasconcelos; de Melo, Laura Gomes Nunes; Gomes, Marilia Brito

2018-01-01

Diabetes nephropathy is a microvascular complication associated with high morbidity and mortality in patients with type 1 diabetes, and its pathogenesis is not fully understood. Our aim was to evaluate the association between levels of serum uric acid and renal function assessed by glomerular filtration rate (GFR) and albuminuria in patients with type 1 diabetes. This is a multicenter, cross-sectional, observational study with 1686 patients, conducted between August 2011 and August 2014 in 14 public clinics from ten Brazilian cities. Renal function was estimated by CKD-EPI (adults) and by Schwartz (adolescents). We analyzed 1686 patients, aged 30.1 ± 12.0, with 15.4 ± 9.3 years of duration of diabetes; 55.8% were female and 54.0% were Caucasians. Serum uric acid was related to renal function, with a mean of 4.8 ± 1.4 (in the normal renal function group) vs 5.2 ± 2.0 (GFR ≥ 60 ml/min and albuminuria) vs 6.5 ± 2.6 mg/dl (GFR uric acid and GFR (r = - 0.316, p uric acid. Considering only patients with normal renal function (n = 1170), a decrease of 2.04 ml/min in the GFR for every increase of 1 mg/dl in Serum uric acid was noted using multivariate analysis. Patients with higher levels of serum uric acid have worse renal function, independently of HbA1c or duration of diabetes, which persisted even in patients with normal renal function. Further prospective studies are necessary to establish if patients with higher serum uric acid may have an elevated risk for developing chronic kidney disease.

Renal Ultrasound in the Diagnosis of the Non-functioning Kidney

International Nuclear Information System (INIS)

Kang, Ik Won; Suh, Jeong Soo

1982-01-01

Renal ultrasound is independent of renal function and capable of renal imaging in impaired or dysplastic renal diseases. Authors reviewed renal ultrasonographic findings of 36 cases which showed non-visualization in intravenous pyelography from Feb. 1979 to Sep. 1982 at Seoul National university Hospital. The results are as follows: 1. Causes of non-visualization of the kidney in IVP were unilateral hydronephrosis(18 cases), renal tuberculosis(7), renal failure(6), renal agenesis(3), tumor(1),and pyonephrosis(1) 2. The sonographic findings were diagnostic in all the cases of unilateral hydronephrosis, renal agenesis and renal tumor. 3. The sonographic findings were not diagnostic but suggestive in more than half cases of renal tuberculosis. 4. Renal ultrasound was not helpful in the diagnosis of renal failure, but useful in delineation of renal size and shape

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

International Nuclear Information System (INIS)

Kawamura, Juichi; Itoh, Hitoshi; Wang, Pan-Chin; Hosokawa, Shinichi; Yoshida, Osamu

1979-01-01

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

Association Between Optic Disc Hemorrhage and Renal Function in South Korea.

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Lee, Jae Yeun; Kim, Joon Mo; Shim, Seong Hee; Lee, Jin Young; Yoo, Chungkwon; Won, Yu Sam; Hyun, Young Youl; Park, Ki Ho

2018-03-01

The purpose of this article is to investigate the relationship between renal function and disc hemorrhage (DH). This retrospective cross-sectional survey was conducted at Kangbuk Samsung Hospital Health Screening Center between August 2012 and July 2013, and a total of 168,044 participants at least 20 years of age who voluntarily visited the health screening center for systemic and ophthalmologic examinations, including fundus photography, were enrolled. All subjects underwent a physical examination and provided samples for laboratory analysis. Digital fundus photographs of both eyes were taken and reviewed. Estimated glomerular filtration rate (eGFR) was calculated from serum creatinine concentration using the Modification of Diet in Renal Disease (MDRD) formula and Cockcroft-Gault (CG) formula. Subjects were stratified by eGFR into quartiles. Among participants, 220 (0.1%) showed DH, and 2376 (1.6%) showed glaucomatous retinal nerve fiber layer defects. The DH group showed higher creatinine and lower eGFR than the non-DH group. A significant trend was observed among higher creatinine, decreased eGFR as obtained by the MDRD and CG formulas, and the prevalence of DH (P for trend ≤0.003, logistic regression analysis). A multiple logistic regression model adjusted for age, sex, hypertension, diabetes, and hyperlipidemia showed that the lowest eGFR quartiles estimated by MDRD and CG were significantly associated with DH compared with the highest eGFR quartile (adjusted odds ratio, 1.96; 95% confidence interval, 1.22-3.14 by CG, 1.86; 95% confidence interval, 1.17-2.96 by MDRD). Renal function impairment was independently associated with a higher prevalence of DH in a South Korean population.

High Prolactin Excretion in Patients with Diabetes Mellitus and Impaired Renal Function.

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Triebel, Jakob; Moreno-Vega, Aura Ileana; Vázquez-Membrillo, Miguel; Nava, Gabriel; García-Franco, Renata; López-Star, Ellery; Baldivieso-Hurtado, Olivia; Ochoa, Daniel; Macotela, Yazmín; Bertsch, Thomas; Martinez de la Escalera, Gonzalo; Clapp, Carmen

2015-01-01

The metabolic clearance of prolactin (PRL) is partially executed by the kidney. Here, we investigate the urine excretion of PRL in patients with Diabetes Mellitus and renal impairment. Serum and urine samples were collected from male, mestizo patients in central Mexico employing a cross-sectional study design. Ninety-eight individuals had either no diabetes and normal renal function (control), diabetes and normal renal function, or diabetes with impaired renal function. PRL was determined by a chemiluminescent immunometric assay; protein, albumin, and creatinine were evaluated using quantitative colorimetric assays. The results were analyzed using ANOVA-testing. Patients with Diabetes Mellitus and renal impairment had significantly higher urine PRL levels than patients with Diabetes Mellitus and normal renal function and control patients. Higher urine PRL levels were associated with lower glomerular filtration rates, higher serum creatinine, and higher urinary albumin-to-creatinine ratios (UACR). Urine PRL levels correlated positively with UACR. Serum PRL levels were similar among groups. Patients with Diabetes Mellitus and impaired renal function demonstrate a high urinary PRL excretion. Urinary PRL excretion in the context of proteinuria could contribute to PRL dysregulation in renal impairment.

Effect of dietary fish oil on renal function and rejection in cyclosporine-treated recipients of renal transplants

NARCIS (Netherlands)

van der Heide, J. J.; Bilo, H. J.; Donker, J. M.; Wilmink, J. M.; Tegzess, A. M.

1993-01-01

Dietary fish oil exerts effects on renal hemodynamics and the immune response that may benefit renal-transplant recipients treated with cyclosporine. To evaluate this possibility, we studied the effect of fish oil on renal function, blood pressure, and the incidence of acute rejection episodes in

Reversal deterioration of renal function accompanied with primary hypothyrodism

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Dragović Tamara

2012-01-01

Full Text Available Introduction. Hypothyroidism is often accompanied with decline of kidney function, or inability to maintain electrolyte balance. These changes are usually overlooked in everyday practice. Early recognition of this association eliminates unnecessary diagnostic procedures that postpone the adequate treatment. Case report. Two patients with elevated serum creatinine levels due to primary autoimmune hypothyroidism, with complete recovery of creatinine clearance after thyroid hormone substitution therapy are presented. The first patient was a young male whose laboratory tests suggested acute renal failure, and the delicate clinical presentation of reduced thyroid function. The second patient was an elderly woman with a history of a long-term signs and symptoms attributed to ageing, including the deterioration of renal function, with consequently delayed diagnosis of hypothyroidism. Conclusion. Serum thyrotropin and thyroxin levels measurement should be done in all cases of renal failure with undefined renal desease, even if the typical clinical presentation of hypothyroidism is absent. Thyroid hormone assays sholud also be performed in all patients with chronic kidney disease whose kidney function is rapidly worsening.

Serum Creatinine in Patients with Advanced Liver Disease Is of Limited Value for Identification of Moderate Renal Dysfunction: Are the Equations for Estimating Renal Function Better?

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Jillian MacAulay

2006-01-01

Full Text Available BACKGROUND: The Cockcroft-Gault formula (CGF is used to estimate the glomerular filtration rate (GFR based on serum creatinine (Cr levels, age and sex. A new formula developed by the Modification of Diet in Renal Disease (MDRD Study Group, based on the patient’s Cr levels, age, sex, race and serum urea nitrogen and serum albumin levels, has shown to be more accurate. However, the best formula to identify patients with advanced liver disease (ALD and moderate renal dysfunction (GFR 60 mL/min/1.73 m2 or less is not known. The aim of the present study was to compare calculations of GFR, using published formulas (excluding those requiring urine collections with standard radionuclide measurement of GFR in patients with ALD.

Impact of ventricular assist device placement on longitudinal renal function in children with end-stage heart failure.

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May, Lindsay J; Montez-Rath, Maria E; Yeh, Justin; Axelrod, David M; Chen, Sharon; Maeda, Katsuhide; Almond, Christopher S D; Rosenthal, David N; Hollander, Seth A; Sutherland, Scott M

2016-04-01

Although ventricular assist devices (VADs) restore hemodynamics in those with heart failure, reversibility of end-organ dysfunction with VAD support is not well characterized. Renal function often improves in adults after VAD placement, but this has not been comprehensively explored in children. Sixty-three children on VAD support were studied. Acute kidney injury (AKI) was defined by Kidney Disease: Improving Global Outcomes criteria. Estimated glomerular filtration rate (eGFR) was determined by the Schwartz method. Generalized linear mixed-effects models compared the pre-VAD and post-VAD eGFR for the cohort and sub-groups with and without pre-VAD renal dysfunction (pre-VAD eGFR renal dysfunction. AKI affected 60.3% (38 of 63), with similar rates in those with and without pre-existing renal dysfunction. Within the cohort, the nadir eGFR occurred 1 day post-operatively (62.9 ml/min/1.73 m(2); IQR, 51.2-88.9 ml/min/1.73 m(2); p renal dysfunction experienced the greatest improvement in the eGFR (β = 0.0051 vs β = 0.0013, p Renal dysfunction is prevalent in children with heart failure undergoing VAD placement. Although peri-operative AKI is common, renal function improves substantially in the first post-operative week and for months thereafter. This is particularly pronounced in those with pre-VAD renal impairment, suggesting that VADs may facilitate recovery and maintenance of kidney function in children with advanced heart failure. Copyright © 2016 International Society for Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.

Association between exposure to ambient air pollution and renal function in Korean adults.

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Kim, Hyun-Jin; Min, Jin-Young; Seo, Yong-Seok; Min, Kyoung-Bok

2018-01-01

Ambient air pollution has a negative effect on many diseases, such as cardiovascular and respiratory diseases. Recent studies have reported a relationship between air pollution and renal function, but the results were limited to exposure to particulate matter (PM). This study was to identify associations between various air pollutants and renal function among Korean adults. Nationwide survey data for a total of 24,407 adults were analyzed. We calculated the estimated glomerular filtration rate (eGFR) for each individual to assess their renal function and used this to categorize those with chronic kidney disease (CKD). To evaluate exposure to ambient air pollution, we used the annual mean concentrations of four ambient air pollutants: PM with an aerodynamic diameter ≤ 10 μm (PM 10 ), nitrogen dioxide (NO 2 ), sulfur dioxide (SO 2 ), and carbon monoxide (CO). We identified significant inverse relationships between the air pollutants PM 10 and NO 2 and eGFR in all statistical adjustment models (all p  ambient air pollutants were significantly related to an increased risk of CKD in the unadjusted model ( p   0.05). Exposures to PM 10 and NO 2 were significantly associated with decreases in eGFR levels, but not CKD, in Korean adults.

99mTc renal tubular function agents: Current status

International Nuclear Information System (INIS)

Eshima, D.; Fritzberg, A.R.; Taylor, A. Jr.

1990-01-01

Orthoiodohippuric (OIH) acid labeled with 131I is a widely used renal radiopharmaceutical agent and has been the standard radiopharmaceutical agent for the measurement of effective renal plasma flow (EPRF). Limitations to the routine clinical use of 131I OIH are related to the suboptimal imaging properties of the 131I radionuclide and its relatively high radiation dose. 123I has been substituted for 131I; however, its high cost and short shelf-life have limited its widespread use. Recent work has centered on the development of a new 99mTc renal tubular function agent, which would use the optimal radionuclidic properties and availability of 99mTc and combine the clinical information provided by OIH. The search for a suitable 99mTc renal tubular function agent has focused on the diamide dithiolate (N2S2), the paraaminohippuric iminodiacetic acid (PAHIDA), and the triamide mercaptide (N3S) donor ligand systems. To date, the most promising 99mTc tubular function agent is the N3S complex: 99mTc mercaptoacetyltriglycine (99mTc MAG3). Studies in animal models in diuresis, dehydration, acid or base imbalance, ischemia, and renal artery stenosis demonstrate that 99mTc MAG3 behaves similarly to 131I OIH. A simple kit formulation is available that yields the 99mTc MAG3 complex in high radiochemical purity. Studies in normal subjects and patients indicate that 99mTc MAG3 is an excellent 99mTc renal tubular agent, but its plasma clearance is only 50% to 60% that of OIH. In an effort to develop an improved 99mTc renal tubular function agent, changes have been made in the core N3S donor ligand system, but to date no agent has been synthesized that is clinically superior to 99mTc MAG3. 61 references

Evaluation of renal function with dynamic MRI-T2-weighted gradient echo technique

International Nuclear Information System (INIS)

Kato, Katsuya

1995-01-01

To evaluate the usefulness of dynamic MRI of kidneys in healthy volunteers and patients with different 24-hour creatinine clearance (Ccr) levels, a dynamic study that employed the T2 weighted gradient echo technique (FLASH: TR/TE=34/25 msec, flip angle= 20 degrees) with single images during breathhold was performed on 10 healthy volunteers and 35 patients, all examined for the Ccr and suspected of having renal parenchymal disease after a phantom study. T1-weighted and dynamic MR imagings were obtained with a 1.5T imager. I analyzed the time-intensity curve of renal cortex and medulla, and defined a cortex decreased ratio (CDR) and medulla decreased ratio (MDR) in comparison with the Ccr. The cortico-medullary difference ratio (CMDR) of T1WI was also compared with the Ccr. The parameters of the T2 dynamic MRI study (CDR, MDR) better correlated with the Ccr than CMDR. Renal function can be quantitatively evaluated with the T2 dynamic MRI and there is a possibility that we can qualitatively evaluate the renal dysfunction and estimate its cause. (author)

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

DEFF Research Database (Denmark)

Kamara, David A; Nielsen, Lene Ryom; Ross, Michael

2014-01-01

No consensus exists on how to define abnormally rapid deterioration in renal function (Rapid Progression, RP). We developed an operational definition of RP in HIV-positive persons with baseline estimated glomerular filtration rate (eGFR) >90ml/min/1.73m2 (using Cockcroft Gault) in the Data...

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

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Sijpkens Yvo WJ

2011-08-01

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

Renal manifestations of primary hyperparathyroidism

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Anurag Ranjan Lila

2012-01-01

Full Text Available Primary hyperparathyroidism (PHPT is associated with nephrolithiasis and nephrocalcinosis. Hypercalciuria is one of the multiple factors that is implicated in the complex pathophysiology of stone formation. The presence of a renal stone (symptomatic or asymptomatic categorizes PHPT as symptomatic and is an indication for parathyroid adenomectomy. Progression of nephrocalcinosis is largely reversible after successful surgery, but the residual risk persists. PHPT is also associated with declining renal function. In case of asymptomatic mild PHPT, annual renal functional assessment is advised. Guidelines suggest that an estimated glomerular filtration rate (eGFR < 60 ml / minute / 1.73 m 2 is an indication for parathyroid adenomectomy. This article discusses how to monitor and manage renal stones and other related renal parameters in case of PHPT.

MR measures of renal perfusion, oxygen bioavailability and total renal blood flow in a porcine model: noninvasive regional assessment of renal function.

Science.gov (United States)

Wentland, Andrew L; Artz, Nathan S; Fain, Sean B; Grist, Thomas M; Djamali, Arjang; Sadowski, Elizabeth A

2012-01-01

Magnetic resonance imaging (MRI) may be a useful adjunct to current methods of evaluating renal function. MRI is a noninvasive imaging modality that has the ability to evaluate the kidneys regionally, which is lacking in current clinical methods. Other investigators have evaluated renal function with MRI-based measurements, such as with techniques to measure cortical and medullary perfusion, oxygen bioavailability and total renal blood flow (TRBF). However, use of all three techniques simultaneously, and therefore the relationships between these MRI-derived functional parameters, have not been reported previously. To evaluate the ability of these MRI techniques to track changes in renal function, we scanned 11 swine during a state of hyperperfusion with acetylcholine and a saline bolus and subsequently scanned during a state of hypoperfusion with the prolonged use of isoflurane anesthesia. For each time point, measurements of perfusion, oxygen bioavailability and TRBF were acquired. Measurements of perfusion and oxygen bioavailability were compared with measurements of TRBF for all swine across all time points. Cortical perfusion, cortical oxygen bioavailability, medullary oxygen bioavailability and TRBF significantly increased with the acetylcholine challenge. Cortical perfusion, medullary perfusion, cortical oxygen bioavailability and TRBF significantly decreased during isoflurane anesthesia. Cortical perfusion (Spearman's correlation coefficient = 0.68; P renal function. Maintenance of the medullary oxygen bioavailability in low blood flow states may reflect the autoregulation particular to this region of the kidney. The ability to non-invasively measure all three parameters of kidney function in a single MRI examination and to evaluate the relationships between these functional parameters is potentially useful for evaluating the state of the human kidneys in situ in future studies.

The pharmacokinetics of peginterferon lambda-1a following single dose administration to subjects with impaired renal function.

Science.gov (United States)

Hruska, Matthew W; Adamczyk, Robert; Colston, Elizabeth; Hesney, Michael; Stonier, Michele; Myler, Heather; Bertz, Richard

2015-09-01

This open label study was conducted to assess the effect of renal impairment (RI) on the pharmacokinetics (PK) of peginterferon lambda-1a (Lambda). Subjects (age 18-75 years, BMI 18-35 kg m(-2) ) were enrolled into one of five renal function groups: normal (n = 12), mild RI (n = 8), moderate RI (n = 8), severe RI (n = 7), end-stage renal disease (ESRD, n = 8) based on estimated glomerular filtration rate (eGFR) calculated using the Modification of Diet in Renal Disease (MDRD) equation. Subjects received a single dose of Lambda (180 µg) subcutaneously on day 1 followed by PK serum sample collections through day 29. Safety, tolerability and immunogenicity data were collected through day 43. PK parameters were estimated and summarized by group. Geometric mean ratios (GMR) and 90% confidence intervals (CIs) were calculated between normal and RI groups. With decreasing eGFR, Lambda exposure (Cmax , AUC) increased while apparent clearance (CL/F) and apparent volume of distribution (V/F) decreased. Relative to subjects with normal renal function (geometric mean AUC = 99.5 ng ml(-1) h), Lambda exposure estimates (AUC) were slightly increased in the mild RI group (geometric mean [90% CI]: 1.20 [0.82, 1.77]) and greater in the moderate (1.95 [1.35, 2.83]), severe RI (1.95 [1.30, 2.93]) and ESRD (1.88 [1.30, 2.73]) groups. Lambda was generally well tolerated. The results demonstrated that RI reduces the clearance of Lambda and suggests that dose modifications may not be required in patients with mild RI but may be required in patients with moderate to severe RI or ESRD. © 2015 The British Pharmacological Society.

Accurate determination of renal function in patients with intestinal urinary diversions

International Nuclear Information System (INIS)

McDougal, W.S.; Koch, M.O.

1986-01-01

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

Evaluation of renal function in children with vesicoureteral reflux

International Nuclear Information System (INIS)

Hioki, Takuichi

1993-01-01

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

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

International Nuclear Information System (INIS)

Baquedano, P.; Orellana, P.; Varas, J.

2002-01-01

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

Eligibility for Statin Treatment in Korean Subjects with Reduced Renal Function: An Observational Study

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Byung Sub Moon

2016-09-01

Full Text Available BackgroundThe purpose of this study was to investigate the relationship between statin eligibility and the degree of renal dysfunction using the Adult Treatment Panel (ATP III and the American College of Cardiology (ACC/American Heart Association (AHA guidelines in Korean adults.MethodsRenal function was assessed in 18,746 participants of the Kangbuk Samsung Health Study from January 2011 to December 2012. Subjects were divided into three groups according to estimated glomerular filtration rate (eGFR: stage 1, eGFR ≥90 mL/min/1.73 m2; stage 2, eGFR 60 to 89 mL/min/1.73 m2; and stages 3 to 5, eGFR <60 mL/min/1.73 m2. Statin eligibility in these groups was determined using the ATP III and ACC/AHA guidelines, and the risk for 10-year atherosclerotic cardiovascular disease (ASCVD was calculated using the Framingham Risk Score (FRS and Pooled Cohort Equation (PCE.ResultsThere were 3,546 (18.9% and 4,048 (21.5% statin-eligible subjects according to ATP III and ACC/AHA guidelines, respectively. The proportion of statin-eligible subjects increased as renal function deteriorated. Statin eligibility by the ACC/AHA guidelines showed better agreement with the Kidney Disease Improving Global Outcomes (KDIGO recommendations compared to the ATP III guidelines in subjects with stage 3 to 5 chronic kidney disease (CKD (κ value, 0.689 vs. 0.531. When the 10-year ASCVD risk was assessed using the FRS and PCE, the mean risk calculated by both equations significantly increased as renal function declined.ConclusionsThe proportion of statin-eligible subjects significantly increased according to worsening renal function in this Korean cohort. ACC/AHA guideline showed better agreement for statin eligibility with that recommended by KDIGO guideline compared to ATP III in subjects with CKD.

Relationship between histopathological changes in post partum renal biopsies and renal function tests of African women with early onset pre-eclampsia.

Science.gov (United States)

Khedun, S M; Naicker, T; Moodley, J

2000-05-01

To improve the diagnostic accuracy of concurrent renal disease in hypertension of pregnancy, biopsy evaluation is essential. In addition, establishing underlying renal disease is important for prognosis on future pregnancies. We therefore designed a study to determine the diagnostic yield of postpartum renal biopsy and the nature and frequency of complications associated with this procedure. Also, to determine relationships, if any, between renal function tests and ultrastructural and histopathological findings. Fifty renal biopsies were performed in the immediate postpartum period in black African women with early onset pre-eclampsia. Each biopsy specimen was placed in a separate container and coded so that sampling was unknown to the electron microscopist. Each biopsy specimen was divided into three parts, and processed and stained for light, fluorescent and transmission electron microscopy using conventional techniques. Renal tissue biopsies were adequate for diagnostic purposes in all cases. There were no complications in any of the 50 patients studied. Ultrastructural examination confirmed the light microscopy findings. In addition the ultrastructural findings showed intramembranous deposits, foot process fusion and mesangial deposits. In 16 patients with normal renal function tests; the biopsies evaluation from these patients showed ultrastructural changes. In the remaining 34 patients with abnormal renal function tests of varying severity; biopsy evaluation from these patients showed both ultrastructural and histopathological changes. Renal biopsy procedure is safe, and ultrastructural and histological findings obtained from postpartum renal biopsies are more informative than the routine renal function tests.

WE-D-204-07: Development of An ImageJ Plugin for Renal Function Quantification: RenalQuant

Energy Technology Data Exchange (ETDEWEB)

Marques da Silva, A; Narciso, L [PUCRS, Porto Alegre, RS (Brazil)

2015-06-15

Purpose: Commercial workstations usually have their own software to calculate dynamic renal functions. However, usually they have low flexibility and subjectivity on delimiting kidney and background areas. The aim of this paper is to present a public domain software, called RenalQuant, capable to semi-automatically draw regions of interest on dynamic renal scintigraphies, extracting data and generating renal function quantification parameters. Methods: The software was developed in Java and written as an ImageJ-based plugin. The preprocessing and segmentation steps include the user’s selection of one time frame with higher activity in kidney’s region, compared with background, and low activity in the liver. Next, the chosen time frame is smoothed using a Gaussian low pass spatial filter (σ = 3) for noise reduction and better delimitation of kidneys. The maximum entropy thresholding method is used for segmentation. A background area is automatically placed below each kidney, and the user confirms if these regions are correctly segmented and positioned. Quantitative data are extracted and each renogram and relative renal function (RRF) value is calculated and displayed. Results: RenalQuant plugin was validated using retrospective 20 patients’ 99mTc-DTPA exams, and compared with results produced by commercial workstation software, referred as reference. The renograms intraclass correlation coefficients (ICC) were calculated and false-negative and false-positive RRF values were analyzed. The results showed that ICC values between RenalQuant plugin and reference software for both kidneys’ renograms were higher than 0.75, showing excellent reliability. Conclusion: Our results indicated RenalQuant plugin can be trustingly used to generate renograms, using DICOM dynamic renal scintigraphy exams as input. It is user friendly and user’s interaction occurs at a minimum level. Further studies have to investigate how to increase RRF accuracy and explore how to solve

Evaluation of absorbed dose in studies of renal function due to 123I/131I (hippuran) e 111In (DPTA)

International Nuclear Information System (INIS)

Vasquez, M.V.; Castillo, C.E.; Rojas, R.; Cabrera, C.; Abanto, D.; Morgan, A.; Diaz, E.E.

2015-01-01

The absorbed dose of the kidneys during renal function studies of adult patients is estimated through biokinetics of radiopharmaceuticals containing the 123 I/ 131 I (hippuran) e 111 In (DPTA). Using the methodology MIRD and representation Cristy-Eckerman for adult kidneys, it is shown that dosimetric contributions of organs of biokinetics 123 I/ 131 I (hippuran) e 111 In (DPTA) are significant, in estimative of dose for renal function studies. Dosimetric contributions (body and whole bladder, kidneys excluding) are given by 11.90% (for 123 I), 4.97% (for 131 I) and 28.32% (for 111 In). In all cases, the dosimetric contributions are mainly due to photons issued by the whole body

Competing Risk of Cardiac Status and Renal Function During Hospitalization for Acute Decompensated Heart Failure.

Science.gov (United States)

Salah, Khibar; Kok, Wouter E; Eurlings, Luc W; Bettencourt, Paulo; Pimenta, Joana M; Metra, Marco; Verdiani, Valerio; Tijssen, Jan G; Pinto, Yigal M

2015-10-01

The aim of this study was to analyze the dynamic changes in renal function in combination with dynamic changes in N-terminal pro-B-type natriuretic peptide (NT-proBNP) in patients hospitalized for acute decompensated heart failure (ADHF). Treatment of ADHF improves cardiac parameters, as reflected by lower levels of NT-proBNP. However this often comes at the cost of worsening renal parameters (e.g., serum creatinine, estimated glomerular filtration rate [eGFR], or serum urea). Both the cardiac and renal markers are validated indicators of prognosis, but it is not yet clear whether the benefits of lowering NT-proBNP are outweighed by the concomitant worsening of renal parameters. This study was an individual patient data analysis assembled from 6 prospective cohorts consisting of 1,232 patients hospitalized for ADHF. Endpoints were all-cause mortality and the composite of all-cause mortality and/or readmission for a cardiovascular reason within 180 days after discharge. A significant reduction in NT-proBNP was not associated with worsening of renal function (WRF) or severe WRF (sWRF). A reduction of NT-proBNP of more than 30% during hospitalization determined prognosis (all-cause mortality hazard ratio [HR]: 1.81; 95% confidence Interval [CI]: 1.32 to 2.50; composite endpoint: HR: 1.36, 95% CI: 1.13 to 1.64), regardless of changes in renal function and other clinical variables. When we defined prognosis, NT-proBNP changes during hospitalization for treatment of ADHF prevailed over parameters for worsening renal function. Severe WRF is a measure of prognosis, but is of lesser value than, and independent of the prognostic changes induced by adequate NT-proBNP reduction. This suggests that in ADHF patients it may be warranted to strive for an optimal decrease in NT-proBNP, even if this induces WRF. Copyright © 2015 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

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

International Nuclear Information System (INIS)

Yao Lixin; Guo Leiming; Li Zuofei; Liu Bo

2009-01-01

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

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

International Nuclear Information System (INIS)

Pedrosa, Ivan; Rafatzand, Khashayar; Robson, Philip; Alsop, David C.; Wagner, Andrew A.; Atkins, Michael B.; Rofsky, Neil M.

2012-01-01

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

Low protein diet and chronic renal failure in Buddhist monks.

Science.gov (United States)

Sitprija, V; Suvanpha, R

1983-08-13

Clinical observations were made in five Buddhist monks with chronic renal failure on a low protein diet. These monks consumed only one meal and meditated three to four times a day. The estimated protein intake was from 15 to 19 g a day. Renal function remained stable over three years of observation. The general condition was satisfactory without any evidence of protein energy malnutrition. The data were compared with those of another group of patients who had a comparable degree of impairment of renal function but who consumed three meals a day of low protein diet. Protein intake was estimated to be from 25 to 30 g a day. These patients developed uraemia with severe renal failure and protein deficiency within three years. The findings support the role of protein restriction in maintenance of renal function in chronic renal failure and perhaps suggest a beneficial role for meditation.

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

International Nuclear Information System (INIS)

Kumar, A.; Hentok, P.; Chandrashekar, N.; Thomas, E.J.; Tripathi, M.; Bal, C.S.; Ghosh, A.; Jailkhani, B.L.; Malhotra, O.P.

2002-01-01

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

Population-based estimation of renal function in healthy young Indian adults based on body mass index and sex correlating renal volume, serum creatinine, and cystatin C

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Rajagopalan P

2016-09-01

Full Text Available Prashanth Rajagopalan,1 Georgi Abraham,2 Yuvaram NV Reddy,2 Ravivarman Lakshmanasami,1 ML Prakash,1 Yogesh NV Reddy2 1Department of General Medicine, Mahatma Gandhi Medical College and Research Institute, Puducherry, 2Department of Nephrology, Madras Medical Mission Hospital, Chennai, India Abstract: This population-based prospective study was undertaken in Mahatma Gandhi Medical College to estimate the renal function in young healthy Indian adults. A young healthy heterogeneous Indian cohort comprising 978 individuals, predominantly medical students, was assessed by a detailed questionnaire, and variables such as height, weight, body mass index (BMI, birth weight, and blood pressure were documented. Laboratory investigations included serum creatinine, serum cystatin C, blood sugar, urine protein, and imaging of the kidneys with ultrasound. The mean age of the cohort was 25±6 years, comprising 672 males and 306 females. The estimated glomerular filtration rates (eGFRs by the Cockcroft–Gault formula for BMI <18.5 kg/m2, 18.5–24.99 kg/m2, 25–29.99 kg/m2, and ≥30 kg/m2 were 71.29±10.45 mL/min, 86.38±13.46 mL/min, 98.88±15.29 mL/min, and 109.13±21.57 mL/min, respectively; the eGFRs using cystatin C for the four groups of BMI were 84.53±18.14 mL/min, 84.01±40.11 mL/min, 79.18±13.46 mL/min, and 77.30±10.90 mL/min, respectively. This study attempts to establish a normal range of serum creatinine and cystatin C values for the Indian population and shows that in young healthy Indian adults, eGFR and kidney volume vary by BMI and sex. Keywords: eGFR, birth weight, renal volume

Effect of Thyroid on Lipid Profile and Renal Function: An ...

African Journals Online (AJOL)

filtration rate.[7,8] However, clinical studies on hypothyroid subjects are very few and not much data is available on how hypothyroidism influences renal function in human beings. Hence, we conducted this observational study to see the relation of the thyroid hormone with hepatic and renal functions. Subjects and Methods.

Relationship between renal hemodynamic status and aging in patients without diabetes evaluated by renal Doppler ultrasonography.

Science.gov (United States)

Kawai, Tatsuo; Kamide, Kei; Onishi, Miyuki; Hongyo, Kazuhiro; Yamamoto-Hanasaki, Hiroko; Oguro, Ryosuke; Maekawa, Yoshihiro; Yamamoto, Koichi; Takeya, Yasushi; Sugimoto, Ken; Ohishi, Mitsuru; Rakugi, Hiromi

2012-10-01

Aging is well known as one of the major causes of a reduced glomerular filtration rate (GFR). The resistive index (RI) measured by renal Doppler ultrasonography (RDU) is thought to be a good indicator of renal vascular resistance induced by arteriosclerosis. In this study, we investigated whether RI could be used to evaluate the pathogenesis of renal damage or the mechanisms of reduction of renal function by aging. We investigated the correlation between RI and multiple clinical parameters and the influence of aging on the renal hemodynamic status of 194 in-patients (mean age 66.2 years) who underwent RDU at our hospital between February 2009 and July 2010. RI was significantly correlated with the age, estimated GFR (eGFR), diastolic blood pressure, pulse pressure, and degree of albuminuria. Subjects aged ≥75 years showed a significantly higher correlation coefficient between eGFR and RI. RI showed a stronger correlation with age in subjects aged ≥75 years compared to eGFR. The present study showed that renal vascular resistance and intra-renal arteriosclerosis had a greater impact on renal function in older than younger subjects, reflecting the possible mechanisms of renal function reduction due to aging.

Renal function following three distinct weight loss dietary strategies during 2 years of a randomized controlled trial.

Science.gov (United States)

Tirosh, Amir; Golan, Rachel; Harman-Boehm, Ilana; Henkin, Yaakov; Schwarzfuchs, Dan; Rudich, Assaf; Kovsan, Julia; Fiedler, Georg M; Blüher, Matthias; Stumvoll, Michael; Thiery, Joachim; Stampfer, Meir J; Shai, Iris

2013-08-01

This study addressed the long-term effect of various diets, particularly low-carbohydrate high-protein, on renal function on participants with or without type 2 diabetes. In the 2-year Dietary Intervention Randomized Controlled Trial (DIRECT), 318 participants (age, 51 years; 86% men; BMI, 31 kg/m(2); mean estimated glomerular filtration rate [eGFR], 70.5 mL/min/1.73 m(2); mean urine microalbumin-to-creatinine ratio, 12:12) with serum creatinine low-fat, Mediterranean, or low-carbohydrate diets. The 2-year compliance was 85%, and the proportion of protein intake significantly increased to 22% of energy only in the low-carbohydrate diet (P vs. low-fat and Mediterranean). We examined changes in urinary microalbumin and eGFR, estimated by Modification of Diet in Renal Disease and Chronic Kidney Disease Epidemiology Collaboration formulas. Significant (P low-carbohydrate (+5.3% [95% CI 2.1-8.5]), Mediterranean (+5.2% [3.0-7.4]), and low-fat diets (+4.0% [0.9-7.1]) with similar magnitude (P > 0.05) across diet groups. The increased eGFR was at least as prominent in participants with (+6.7%) or without (+4.5%) type 2 diabetes or those with lower baseline renal function of eGFR low-carbohydrate diet is as safe as Mediterranean or low-fat diets in preserving/improving renal function among moderately obese participants with or without type 2 diabetes, with baseline serum creatinine <176 μmol/L. Potential improvement is likely to be mediated by weight loss-induced improvements in insulin sensitivity and blood pressure.

Inhibition of WISE preserves renal allograft function.

Science.gov (United States)

Qian, Xueming; Yuan, Xiaodong; Vonderfecht, Steven; Ge, Xupeng; Lee, Jae; Jurisch, Anke; Zhang, Li; You, Andrew; Fitzpatrick, Vincent D; Williams, Alexia; Valente, Eliane G; Pretorius, Jim; Stevens, Jennitte L; Tipton, Barbara; Winters, Aaron G; Graham, Kevin; Harriss, Lindsey; Baker, Daniel M; Damore, Michael; Salimi-Moosavi, Hossein; Gao, Yongming; Elkhal, Abdallah; Paszty, Chris; Simonet, W Scott; Richards, William G; Tullius, Stefan G

2013-01-01

Wnt-modulator in surface ectoderm (WISE) is a secreted modulator of Wnt signaling expressed in the adult kidney. Activation of Wnt signaling has been observed in renal transplants developing interstitial fibrosis and tubular atrophy; however, whether WISE contributes to chronic changes is not well understood. Here, we found moderate to high expression of WISE mRNA in a rat model of renal transplantation and in kidneys from normal rats. Treatment with a neutralizing antibody against WISE improved proteinuria and graft function, which correlated with higher levels of β-catenin protein in kidney allografts. In addition, treatment with the anti-WISE antibody reduced infiltration of CD68(+) macrophages and CD8(+) T cells, attenuated glomerular and interstitial injury, and decreased biomarkers of renal injury. This treatment reduced expression of genes involved in immune responses and in fibrogenic pathways. In summary, WISE contributes to renal dysfunction by promoting tubular atrophy and interstitial fibrosis.

Renal functional CT studies of patients with nephrolithotomy

International Nuclear Information System (INIS)

Yokoyama, Masayoshi; Fujita, Kiyoshi; Watanabe, Kiyotaka; Ochi, Kenji; Takeuchi, Masafumi

1985-01-01

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

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

The influence of angiotensin-converting enzyme (ACE) inhibition on renal tubular function in progressive chronic nephropathy was investigated in 69 patients by the lithium clearance (C(Li)) method. Studies were done repeatedly for up to 2 years during a controlled trial on the effect of enalapril...... on progression of renal failure. The pattern of proteinuria was followed over the first 9 months. At baseline, the glomerular filtration rate (GFR) was 5 to 68 mL/min. Absolute proximal tubular reabsorption rate of fluid (APR), estimated as the difference between GFR and C(Li), was 1 to 54 mL/min. Calculated...... 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

Late evaluation of the relationship between morphological and functional renal changes and hypertension after non-operative treatment of high-grade renal injuries

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Pereira Júnior Gerson

2012-08-01

Full Text Available Abstract Objective To evaluate the anatomical and functional renal alterations and the association with post-traumatic arterial hypertension. Methods The studied population included patients who sustained high grades renal injury (grades III to V successfully non-operative management after staging by computed tomography over a 16-year period. Beyond the review of medical records, these patients were invited to the following protocol: clinical and laboratory evaluation, abdominal computed tomography, magnetic resonance angiography, DMSA renal scintigraphy, and ambulatory blood pressure monitoring. The hypertensive patients also were submitted to dynamic renal scintigraphy (99mTc EC, using captopril stimulation to verify renal vascular etiology. Results Of the 31 patients, there were thirteen grade III, sixteen grade IV (nine lacerations, and seven vascular lesions, and two grade V injuries. All the patients were asymptomatic and an average follow up post-injury of 6.4 years. None had abnormal BUN or seric creatinine. The percentage of renal volume reduction correlates with the severity as defined by OIS. There was no evidence of renal artery stenosis in Magnetic Resonance angiography (MRA. DMSA scanning demonstrated a decline in percentage of total renal function corresponding to injury severity (42.2 ± 5.5% for grade III, 35.3 ± 12.8% for grade IV, 13.5 ± 19.1 for grade V. Six patients (19.4% had severe compromised function ( Conclusions Late results of renal function after conservative treatment of high grades renal injuries are favorable, except for patients with grades IV with vascular injuries and grade V renal injuries. Moreover, arterial hypertension does not correlate with the grade of renal injury or reduction of renal function.

Percutaneous renal angioplasty and stenting: application of embolic protection device in patients with normal renal function

International Nuclear Information System (INIS)

Tong Xiaoqiang; Yang Ming; Wang Jian; Song Li; Wang Chao; Lv Yongxing; Sun Hongliang; Zou Yinghua; Yin Ming

2007-01-01

Objective: To investigate the Value of embolic protection device (EPD)in renal artery stenting (RAS)for the patients with normal renal function. Methods: Total 24 patients (26 renal arteries) suffering from renal artery stenosis with normal serum creatinine were divided into two groups: EPD group (n12)and non-EPD group (n=12). Serum creatinine was calculated and analized statistically between the two groups, 1 month and 6months after stenting respectively, and followed by comparisons taking inside of each group and between both groups. Results: Serum creatinine of the EPD and non-EPD groups before, 1 month and 6 month after stenting were(99.18 ± 18.26) μmol/L, (101.73 ± 12.65) μmol/L, (96.82 ± 15.81) μmol/L and (100.18 ± 19.81) μmol/L, (107.36 ± 29.49) μmol/L, (127.64 ± 88.05) μmol/L, respectively; showing no significant difference inside each group individually (P>0.05), and also no statistically significant difference between the two groups (P>0.05). Conclusion: For the patients suffering from renal artery stenosis with normal serum creatinine, application of EPD may have no impact on renal function. Further evaluation is needed. (authors)

Renal artery stenting in solitary functioning kidneys: Technical and clinical results

International Nuclear Information System (INIS)

Sahin, Sinan; Cimsit, Cagatay; Andac, Nurten; Baltacioglu, Feyyaz; Tuglular, Serhan; Akoglu, Emel

2006-01-01

Objective: To evaluate the clinical and technical results of renal artery stenting for the treatment of renovascular hypertension and renal failure in patients with solitary functioning kidney. Materials and methods: Fifteen patients with solitary functioning kidney underwent renal artery stenting and were followed up for 12-60 months. Before the procedures, systolic and diastolic blood pressures and serum creatinine levels were measured and the number of antihypertensive drugs was recorded and followed up after stenting. In case of restenosis, either in-stent percutaneous transluminal renal angioplasty or stent-in-stent placement was performed. Results: Primary technical success rate was 100%. One lesion was nonostial while 14 were ostial. Primary patency rates were 100% for 6 months, 92.3% for 12 months, and 69.2% for 24 months. The secondary patency rate at 24 months was 100%. The differences between the baseline and postprocedural values of systolic blood pressures, diastolic blood pressures and the number of antihypertensive drug were statistically significant (P < 0.05), except the values of serum creatinine. Hypertension was cured in 1 (6.7%) patient, improved in 4 (26.6%) and stabilized in 10 (66.7%) patients. Renal function improved in 9 (60%), stabilized in 4 (26.6%), and deteriorated in 2 (13.4%) patients. Minor complication rate was 13.4% and major complication rate was 13.4%. Conclusion: Revascularization of renal artery stenosis using stent in solitary functioning kidneys is a safe and efficient procedure with high primary technical results, low restenosis rates and acceptable complication rates. It has an improving and controlling effect on blood pressure and renal functions

Renal artery stenting in solitary functioning kidneys: Technical and clinical results

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Sahin, Sinan [Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Hospital, Department of Radiology, Istanbul (Turkey)]. E-mail: sinan.sahin@e-kolay.net; Cimsit, Cagatay [Marmara University, School of Medicine, Department of Radiology, Istanbul (Turkey); Andac, Nurten [Marmara University, School of Medicine, Department of Radiology, Istanbul (Turkey); Baltacioglu, Feyyaz [Marmara University, School of Medicine, Department of Radiology, Istanbul (Turkey); Tuglular, Serhan [Marmara University, School of Medicine, Department of Nephrology, Istanbul (Turkey); Akoglu, Emel [Marmara University, School of Medicine, Department of Nephrology, Istanbul (Turkey)

2006-01-15

Objective: To evaluate the clinical and technical results of renal artery stenting for the treatment of renovascular hypertension and renal failure in patients with solitary functioning kidney. Materials and methods: Fifteen patients with solitary functioning kidney underwent renal artery stenting and were followed up for 12-60 months. Before the procedures, systolic and diastolic blood pressures and serum creatinine levels were measured and the number of antihypertensive drugs was recorded and followed up after stenting. In case of restenosis, either in-stent percutaneous transluminal renal angioplasty or stent-in-stent placement was performed. Results: Primary technical success rate was 100%. One lesion was nonostial while 14 were ostial. Primary patency rates were 100% for 6 months, 92.3% for 12 months, and 69.2% for 24 months. The secondary patency rate at 24 months was 100%. The differences between the baseline and postprocedural values of systolic blood pressures, diastolic blood pressures and the number of antihypertensive drug were statistically significant (P < 0.05), except the values of serum creatinine. Hypertension was cured in 1 (6.7%) patient, improved in 4 (26.6%) and stabilized in 10 (66.7%) patients. Renal function improved in 9 (60%), stabilized in 4 (26.6%), and deteriorated in 2 (13.4%) patients. Minor complication rate was 13.4% and major complication rate was 13.4%. Conclusion: Revascularization of renal artery stenosis using stent in solitary functioning kidneys is a safe and efficient procedure with high primary technical results, low restenosis rates and acceptable complication rates. It has an improving and controlling effect on blood pressure and renal functions.

Effect of region assignment on relative renal blood flow estimates using radionuclides

International Nuclear Information System (INIS)

Harris, C.C.; Ford, K.K.; Coleman, R.E.; Dunnick, N.R.

1984-01-01

To determine the value of the initial phase of the Tc-99m DTPA renogram in the direct estimation of relative renal blood flow in dogs, the ratios of the slopes of renal time-activity curves were compared with the ratios of measured blood flow. Radionuclide results were dependent on region-of-interest (ROI) and background ROI assignment, and correlated well with measured relative flow only with a maximum renal outline region. Curve slope ratios correlated well with measured flow ratios with and without background correction, while 1- to 2-minute uptake ratios correlated well only when corrected for background

The effect of cinacalcet on bone remodeling and renal function in transplant patients with persistent hyperparathyroidism.

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Schwarz, Anke; Merkel, Saskia; Leitolf, Holger; Haller, Hermann

2011-03-15

Parathyroidectomy is associated with renal functional losses in transplant patients; cinacalcet offers an attractive alternative. We performed a prospective observational study in 58 patients with persisting hyperparathyroidism after renal transplantation (Ca≥2.6 mmol/L) and impaired renal transplant function (estimated glomerular filtration rate [eGFR] bone-specific alkaline phosphatase, osteocalcin, and telopeptide at 0, 1, 2, 3, 6, 9, and 12 months of cinacalcet treatment. Fractional excretion of calcium and phosphorus (n=24) were monitored at 0 and 1 month. At inclusion, creatinine was 181±70 μmol/L, eGFR 43±19 mL/min, PTH 371±279 pg/mL, and Ca 2.73±0.22 mmol/L. We observed nephrocalcinosis in 58% of biopsied patients at enrollment. After cinacalcet, Ca decreased significantly and normalized at nearly any measurement. Phosphorus increased significantly at months 1, 9, and 12. PTH decreased significantly, but only at months 9 and 12 and did not normalize. Bone-specific alkaline phosphatase increased significantly (>normal) by month 12. eGFR decreased and serum creatinine increased at all time points. The Δ(creatinine) % increase correlated significantly with the Δ(PTH) % decrease at month 1 and 12. Telopeptide and alkaline phosphatase correlated with PTH and telopeptide also correlated with serum creatinine. Calcium-phosphorus homeostasis in hypercalcemic renal transplant patients normalizes under cinacalcet and PTH decreases, albeit not to normal. The renal functional decline could be PTH mediated, analogous to the effects observed after parathyroidectomy.

Renal function and plasma volume following ultramarathon cycling.

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Neumayr, G; Pfister, R; Hoertnagl, H; Mitterbauer, G; Prokop, W; Joannidis, M

2005-01-01

In recreational cyclists marathon cycling influences renal function only on a minimal scale. Respective information on extreme ultramarathon cycling in better trained athletes is not available. The objective was to evaluate the renal and haematological effects of ultraendurance cycling in the world's best ultramarathon cyclists. Creatinine (CR), urea, haemoglobin (Hb), haematocrit (Hct) and plasma volume (PV) were investigated in 16 male ultramarathon cyclists during the 1st Race Across the Alps in 2001 (distance: 525 km; cumulative altitude difference: 12,600 m). All renal functional parameters were normal pre-exercise. During the race serum CR, urea and uric acid rose significantly by 33, 97 % and 18 % (p training kilometers. The serum urea/CR ratio rose above 40 in 12 athletes (75 %). Mean fractional sodium excretion and fractional uric acid excretion fell below 0.5 % (p 0.40; p training.

Ankle-brachial index by automated method and renal function

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Ricardo Pereira Silva

2017-05-01

Full Text Available Background The Ankle-brachial index (ABI is a non-invasive method used for the diagnosis of peripheral arterial occlusive disease (PAOD. Aims To determine the clinical features of patients submitted to ABI measurement by automatic method. To investigate association between ABI and renal function. Methods The present is a cross-sectional study. The study was performed in a private clinic in the city of Fortaleza (Ce- Brazil. For ABI analysis, we utilized automatic methodology using a Microlife device. Data collection took place from March 2012 to January 2016. During this period, ABI was measured in 375 patients aged >50 years, who had a diagnosis of hypertension, diabetes or vascular disease. Results Of the 375 patients, 18 were categorized as having abnormal ABI (4.8 per cent and 357 were normal ABI (95.2 per cent. Patients with abnormal ABI showed older mean age when compared to patients with normal ABI. Among patients with normal renal function, only 0.95 per cent showed abnormal ABI; among patients with abnormal renal function, 6 per cent showed abnormal ABI. Conclusion 1 No differences were observed when comparing the groups regarding gender or the prevalence of hypertension, diabetes, dyslipidaemia or CAD. 2 Group with abnormal ABI had renal function greater impairment.

Waist Circumference, Not Body Mass Index, Is Associated with Renal Function Decline in Korean Population: Hallym Aging Study

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Oh, Hyunju; Quan, Shan Ai; Jeong, Jin-Young; Jang, Soong-Nang; Lee, Jung Eun; Kim, Dong-Hyun

2013-01-01

Background Prospective investigation of obesity and renal function decline in Asia is sparse. We examined the associations of body mass index (BMI) and waist circumference (WC) with renal function decline in a prospective study of Korean population. Methods A total of 454 participants who had baseline estimated glomerular filtration rate (eGFR) levels of more than 60 mL/min/1.73 m2 in Hallym Aging Study (HAS) were included and followed for 6 years. Renal function decline was defined as follows: (1) an eGFR decline ≥3 mL/min/1.73 m2/year (n = 82 cases); (2) an eGFR decrease of 20% or greater (n = 87 cases) at follow-up; (3) an eGFR decrease of 20% greater at follow-up or eGFR decline ≥3 mL/min/1.73 m2/year (n = 91 cases); and (4) an eGFR 95 cm in men or >90 cm in women with ≤90 cm in men or ≤85 cm in women, ORs (95% CIs) ranged from 2.31 (1.14–4.69) to 2.78 (1.19–6.50) for the 4 definitions of renal function decline (all p-values for trend Korean population. Our results provide important evidence that simple measurement of central fat deposition rather than BMI could predict decline in renal function in Korean population. PMID:23536858

The effects of environmental chemicals on renal function.

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Kataria, Anglina; Trasande, Leonardo; Trachtman, Howard

2015-10-01

The global incidence of chronic kidney disease (CKD) is increasing among individuals of all ages. Despite advances in proteomics, genomics and metabolomics, there remains a lack of safe and effective drugs to reverse or stabilize renal function in patients with glomerular or tubulointerstitial causes of CKD. Consequently, modifiable risk factors that are associated with a progressive decline in kidney function need to be identified. Numerous reports have documented the adverse effects that occur in response to graded exposure to a wide range of environmental chemicals. This Review summarizes the effects of such chemicals on four aspects of cardiorenal function: albuminuria, glomerular filtration rate, blood pressure and serum uric acid concentration. We focus on compounds that individuals are likely to be exposed to as a consequence of normal consumer activities or medical treatment, namely phthalates, bisphenol A, polyfluorinated alkyl acids, dioxins and furans, polycyclic aromatic hydrocarbons and polychlorinated biphenyls. Environmental exposure to these chemicals during everyday life could have adverse consequences on renal function and might contribute to progressive cumulative renal injury over a lifetime. Regulatory efforts should be made to limit individual exposure to environmental chemicals in an attempt to reduce the incidence of cardiorenal disease.

Temporal trends in renal function and birthweight in Japanese adolescent males (1998-2015).

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Kanda, Takeshi; Takeda, Ayano; Hirose, Hiroshi; Abe, Takayuki; Urai, Hidenori; Inokuchi, Mikako; Wakino, Shu; Tokumura, Mitsuaki; Itoh, Hiroshi; Kawabe, Hiroshi

2018-02-01

Low birthweight (LBW) is a worldwide public health problem, demonstrating an increasing incidence in developed countries, including Japan. LBW is also a risk factor for later development of chronic kidney disease (CKD). To date, studies have not evaluated the population impacts of increasing LBW rates on renal function. Estimated glomerular filtration rate (eGFR) was evaluated in 3737 Japanese adolescent males (15-16 years old) using annual cross-sectional data over an 18-year period (1998-2015). Between the initial (1998-2003) and final (2010-15) periods of the study, the mean birthweight decreased from 3213.4 ± 383.8 to 3116.2 ± 382.3 g and the LBW rate increased from 2.5 to 5.5% (both P ≤ 0.01). Additionally, the mean eGFR decreased from 105.1 ± 15.9 to 97.4 ± 13.8 mL/min/1.73 m2 and the prevalence of mildly reduced renal function (eGFR ≤ 60- <90 mL/min/1.73 m2) increased from 16.4 to 30.0% (both P ≤ 0.01), most evident in the LBW group (from 10.3 to 41.7%, P ≤0.01). The prevalence of proteinuria also increased significantly. Mildly reduced renal function was significantly associated with LBW [odds ratio (LBW 3000-3999 g) 1.51; 95% confidence interval 1.00-2.55; P = 0.047]. In this population of Japanese adolescents, the frequency of mildly reduced renal function increased as the LBW frequency increased. Our findings may have implications for the broader Japanese population as well as for other populations in which the prevalence of LBW is increasing. © The Author 2017. Published by Oxford University Press on behalf of ERA-EDTA.

Forty-five-year follow-up on the renal function after spinal cord injury

DEFF Research Database (Denmark)

Elmelund, M; Oturai, P S; Toson, B

2016-01-01

rate (GFR) ⩽75% of expected according to age and gender) was 58%. The cumulative risk of severe renal deterioration (functional distribution outside 30-70% on renography or relative GFR⩽51%) was 29% after 45 years postinjury. Only dilatation of UUT and renal/ureter stone requiring removal significantly...... increased the risk of moderate and severe renal deterioration. CONCLUSION: Renal deterioration occurs at any time after injury, suggesting that lifelong follow-up examinations of the renal function are important, especially in patients with dilatation of UUT and/or renal/ureter stones....

End-Stage Renal Disease After Renal Surgery in Patients with Normal Preoperative Kidney Function: Balancing Surgical Strategy and Individual Disorders at Baseline.

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Capitanio, Umberto; Larcher, Alessandro; Terrone, Carlo; Antonelli, Alessandro; Volpe, Alessandro; Fiori, Cristian; Furlan, Maria; Dehò, Federico; Minervini, Andrea; Serni, Sergio; Porpiglia, Francesco; Trevisani, Francesco; Salonia, Andrea; Carini, Marco; Simeone, Claudio; Montorsi, Francesco; Bertini, Roberto

2016-10-01

Although nephron-sparing surgery (NSS) has demonstrated benefit in terms of renal function preservation, it is unclear whether NSS might also decrease the risk of end-stage renal disease (ESRD) relative to radical nephrectomy (RN). In the current paper, we aimed to report the rate and the predictors of ESRD after surgery, accounting for detailed individual baseline characteristics and comorbidities. A multi-institutional collaboration among five European tertiary care centers allowed study of 2027 patients with normal preoperative renal function and a clinically localized T1abN0M0 renal mass. Cox regression analyses were used to predict the risk of ESRD (defined as the onset of a postoperative estimated glomerular filtration rate kidney disease. Univariable ESRD rates at 5 and 10 yr of follow-up were virtually equivalent for patients who underwent NSS (1.5% and 2.5%, respectively) versus RN (1.9% and 2.7%, respectively; hazard ratio [HR]: 0.8; 95% confidence interval [CI], 0.4-1.6). However, diabetes, smoking, uncontrolled hypertension, and other comorbidities were consistently more frequent in the NSS group relative to their RN counterparts. After adjusting for detailed baseline individual characteristics, NSS was shown to have an independent protective effect relative to RN (HR: 0.4; 95% CI, 0.2-0.8; p=0.02) at multivariable analyses. After accounting for individual baseline characteristics, such as age, diabetes, uncontrolled hypertension, or other comorbidities, partial nephrectomy independently protects against end-stage renal disease and the consequent need for dialysis relative to radical nephrectomy. Copyright © 2016 European Association of Urology. Published by Elsevier B.V. All rights reserved.

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

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

2012-02-15

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

Prediction of renal functional recovery after relief of upper urinary tract obstruction

International Nuclear Information System (INIS)

Kalika, V.; Bard, R.H.; Iloreta, A.; Freeman, L.M.; Heller, S.; Blaufox, M.D.

1981-01-01

Renal cortical regions of interest were used prospectively to predict recoverability of renal function in 27 patients with unilateral or bilateral urinary tract obstruction. In these 27 patients 36 kidneys with short-term or long-term obstruction were studied. The 131iodine radiohippuran renogram curves were generated from areas of interest from the renal cortex and from the whole kidney. Curves generated during obstruction were evaluated qualitatively to determine if regional cortical renograms exhibited a more normal appearance than total kidney curves. After relief of obstruction renograms generated from the whole kidney were evaluated for evidence of renal functional recovery. Cortical curves obtained before relief obstruction were judged normal, with an abnormal whole kidney renogram in 20 of 36 kidneys. The whole kidney renogram improved after relief of obstruction in all 20 cases. Cortical curves for the remaining 16 kidneys before relief of obstruction had the same abnormal appearance as the whole kidney renogram. After relief of obstruction no evidence of kidney function improvement as measured by the renogram was evident in 14 kidneys. The over-all accuracy of this test of renal functional recoverability was 94 per cent. These data support the hypothesis that when cortical curves appear more normal than total kidney curves there is a strong likelihood of postoperative improvement in renal function when the obstruction is relieved. Abnormal cortical curves are associated with a poor prognosis for renal functional improvement

Renal function in heart transplant patients after switch to combined mammalian target of rapamycin inhibitor and calcineurin inhibitor therapy

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Helmschrott M

2017-06-01

Full Text Available Matthias Helmschrott,1 Rasmus Rivinius,1 Thomas Bruckner,2 Hugo A Katus,1 Andreas O Doesch1 1Department of Cardiology, Angiology, Pneumology, 2Institute for Medical Biometry and Informatics, University of Heidelberg, Heidelberg, Germany Background: A calcineurin inhibitor (CNI-based immunosuppression combined with mammalian target of rapamycin inhibitors (mTORs seems to be attractive in patients after heart transplantation (HTX in special clinical situations, for example, in patients with adverse drug effects of prior immunosuppression. Previous studies in patients after HTX detected advantageous effects regarding renal function of a tacrolimus (TAC-based vs cyclosporine-A (CSA-based immunosuppression (in combination with mycophenolate mofetil. However, data regarding renal function after HTX in mTOR/CNI patients remain limited. Aim: Primary end point of the present study was to analyze renal function in HTX patients 1 year after switch to an mTOR/CNI-based immunosuppression. Methods: Data of 80 HTX patients after change to mTOR/CNI-based immunosuppression were retrospectively analyzed. Renal function was assessed by measured serum creatinine and by estimated glomerular filtration rate (eGFR calculated from Modification of Diet in Renal Disease equation. Results: Twenty-nine patients received mTOR/CSA-based treatment and 51 patients received mTOR/TAC-based therapy. At time of switch and at 1-year follow-up, serum creatinine and eGFR did not differ significantly between both study groups (all P=not statistically significant. Analysis of variances with repeated measurements detected a similar change of renal function in both study groups. Conclusion: The present study detected no significant differences between both mTOR/CNI study groups, indicating a steady state of renal function in HTX patients after switch of immunosuppressive regimen. Keywords: heart transplantation, cyclosporine A, tacrolimus, risk factors

Late renal function after upper abdominal irradiation

International Nuclear Information System (INIS)

Morris, Monica M.; Willett, Christopher G.

1997-01-01

Purpose: This study assesses the late renal function and complications following upper abdominal irradiation. Methods and Materials: Eighty-six adult patients were identified who were treated with curative intent to the upper abdomen, received greater than 50% unilateral kidney irradiation to doses of at least 26 Gy, and survived for 1 year or more. Following treatment, the clinical course, blood pressure, addition of anti-hypertensive medications, serum creatinine and creatinine clearance were determined. Creatinine clearance was calculated by the formula: creatinine clearance equals [(140 - age) x (weight in kilograms)] / (72 x serum creatinine), which has a close correlation to creatinine clearances measured by 24 hour urine measurement. The percent change in creatinine clearance from pre-treatment values was analyzed. Mean follow-up was 6.7 years. Seventeen patients were followed for 11 or more years. Results: Of the 16 patients with pre-radiotherapy hypertension, eight required an increase in the number of medications for control and eight required no change in medication. Twenty-one patients developed hypertension in follow-up, 15 of whom required no medication. One patient developed malignant hypertension on the basis of renal artery stenosis. Acute or chronic renal failure was not observed in any patient. The serum creatinine for all 86 patients prior to irradiation was below 2 mg/100 ml; in follow-up it rose to between 2-3 mg/100 ml in five patients. On univariate analysis, older patient age, female sex, pre-existing hypertension and initially abnormal renal function (creatinine clearance <90mg/ml) were significantly correlated with later poor creatinine clearance (<50 mg/ml). Conclusions: After significant unilateral kidney irradiation, patients demonstrated a laboratory trend to increased creatinine and decreased creatinine clearance. With long-term follow-up, these physiologic changes did not appear to translate into a clinically relevant alteration in

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

DEFF Research Database (Denmark)

Byrne, Christina; Abdulla, Jawdat

2014-01-01

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

Clinical and Biochemical Characteristics of Brain-Dead Donors as Predictors of Early- and Long-Term Renal Function After Transplant.

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Kwiatkowska, Ewa; Domański, Leszek; Bober, Joanna; Safranow, Krzysztof; Pawlik, Andrzej; Ciechanowski, Kazimierz; Wiśniewska, Magda; Kędzierska, Karolina

2017-08-01

Organs from brain-dead donors are the main source of allografts for transplant. Comparisons between living-donor and brain-dead donor kidneys show that the latter are more likely to demonstrate delayed graft function and lower long-term survival. This study aimed to assess the effects of various clinical and biochemical factors of donors on early- and long-term renal function after transplant. We analyzed data from kidney recipients treated between 2006 and 2008 who received organs from brain-dead donors. Data from 54 donors and 89 recipients were analyzed. No relation was observed between donor sodium concentration and the presence of delayed graft function. Donor height was positively correlated with creatinine clearance in recipients in the 1 to 3 months after renal transplant. Donor diastolic blood pressure was negatively correlated with estimated glomerular filtration rate throughout the observation period. Donor age was negatively correlated with the allograft recipient's estimated glomerular filtration rate throughout 4 years of observation. Donor estimated glomerular filtration rate was positively correlated with that of the recipient throughout 3 years of observation. The results of this study indicate that various factors associated with allograft donors may influence graft function.

Associations of proanthocyanidin intake with renal function and clinical outcomes in elderly women.

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Kerry L Ivey

Full Text Available Progression to chronic renal failure involves accelerated atherosclerosis and vascular calcification. Oxidative stress and endothelial dysfunction play a role in renal failure pathophysiology. In addition to improving vascular health and function, proanthocyanidins have been shown to exert renoprotective effects in animal models. Thus we hypothesize that proanthocyanidins may contribute to the maintenance of healthy renal function.Determine the association of habitual proanthocyanidin intake with renal function and the risk of clinical renal outcomes in a population of elderly women.948 women aged over 75 y, free of prevalent renal disease at baseline, were randomly selected from ambulant Caucasian women. Proanthocyanidin consumption was determined using a validated food frequency questionnaire and the United States Department of Agriculture proanthocyanidin food content database. Fasting serum cystatin C and creatinine were assessed at baseline. Renal failure hospitalisations and deaths were assessed over 5 years of follow-up through the Western Australia Data Linkage System.Compared to participants with low consumption, participants in the highest tertile of proanthocyanidin intake had a 9% lower cystatin C concentration (P<0.001. High proanthocyanidin consumers were at 50% lower risk of moderate chronic kidney insufficiency, and 65% lower risk of experiencing a 5-year renal disease event (P<0.05. These relationships remained significant following adjustment for renal disease risk factors and diet-related potential confounders.Increased consumption of proanthocyanidins was associated with better renal function and substantially reduced renal associated events, which has been supported by mechanistic and animal model data. Proanthocyanidin intake should be further examined as a dietary contributor to better renal health.

Worsening renal function in heart failure: the need for a consensus definition.

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Sheerin, Noella J; Newton, Phillip J; Macdonald, Peter S; Leung, Dominic Y C; Sibbritt, David; Spicer, Stephen Timothy; Johnson, Kay; Krum, Henry; Davidson, Patricia M

2014-07-01

Acute decompensated heart failure is a common cause of hospitalisation. This is a period of vulnerability both in altered pathophysiology and also the potential for iatrogenesis due to therapeutic interventions. Renal dysfunction is often associated with heart failure and portends adverse outcomes. Identifying heart failure patients at risk of renal dysfunction is important in preventing progression to chronic kidney disease or worsening renal function, informing adjustment to medication management and potentially preventing adverse events. However, there is no working or consensus definition in international heart failure management guidelines for worsening renal function. In addition, there appears to be no concordance or adaptation of chronic kidney disease guidelines by heart failure guideline development groups for the monitoring of chronic kidney disease in heart failure. Our aim is to encourage the debate for an agreed definition given the prognostic impact of worsening renal function in heart failure. We present the case for the uptake of the Acute Kidney Injury Network criteria for acute kidney injury with some minor alterations. This has the potential to inform study design and meta-analysis thereby building the knowledgebase for guideline development. Definition consensus supports data element, clinical registry and electronic algorithm innovation as instruments for quality improvement and clinical research for better patient outcomes. In addition, we recommend all community managed heart failure patients have their baseline renal function classified and routinely monitored in accordance with established renal guidelines to help identify those at increased risk for worsening renal function or progression to chronic kidney disease. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

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

OpenAIRE

Barbudo-Selmi,Glenda Ramalho; Carvalho,Marileda Bonafim; Selmi,André Luis; Martins,Silvio Emílio Cuevas

2004-01-01

The purpose of this study was to evaluate periodontal disease (PD) in dogs with chronic renal failure (CRF) and to compare it to PD in dogs with normal renal function (NRF). Twelve dogs with CRF and 24 dogs with NRF, all presenting dental pocket formation, were compared. In all dogs, serum creatinine, blood urea nitrogen, urine specific gravity and total red and white blood cells were determined. A complete oral examination was also performed including evaluation of bacterial plaque, gingivit...

Analysis of renal blood flow and renal volume in normal fetuses and in fetuses with a solitary functioning kidney.

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Hindryckx, An; Raaijmakers, Anke; Levtchenko, Elena; Allegaert, Karel; De Catte, Luc

2017-12-01

To evaluate renal blood flow and renal volume for the prediction of postnatal renal function in fetuses with solitary functioning kidney (SFK). Seventy-four SFK fetuses (unilateral renal agenesis [12], multicystic dysplastic kidney [36], and severe renal dysplasia [26]) were compared with 58 healthy fetuses. Peak systolic velocity (PSV), pulsatility index (PI), and resistance index (RI) of the renal artery (RA) were measured; 2D and 3D (VOCAL) volumes were calculated. Renal length and glomerular filtration rate (GFR) were obtained in SFK children (2 years). Compared with the control group, the PSV RA was significantly lower in nonfunctioning kidneys and significantly higher in SFK. Volume measurements indicated a significantly larger volume of SFK compared with healthy kidneys. All but 4 children had GFR above 70 mL/min/1.73 m 2 , and compensatory hypertrophy was present in 69% at 2 years. PSV RA and SFK volume correlated with postnatal renal hypertrophy. No correlation between prenatal and postnatal SFK volume and GFR at 2 years was demonstrated. Low PSV RA might have a predictive value for diagnosing a nonfunctioning kidney in fetuses with a SFK. We demonstrated a higher PSV RA and larger renal volume in the SFK compared with healthy kidneys. © 2017 John Wiley & Sons, Ltd.

Renal function assessed by 99mTc-DMSA scintigraphy before and after percutaneous nephrostolithotripsy (PNL)

International Nuclear Information System (INIS)

Sakurai, Masaki; Hioki, Takuichi; Kitano, Tokio; Nakagawa, Tsuyoshi; Yamaguchi, Nobuo; Kawamura, Juichi

1988-01-01

99m Tc-DMSA scintigraphy was carried out in 43 patients with unilateral renal stones before and after PNL. This study was repeated about one year after PNL in 12 patients. DMSA renal uptake was calculated two hours after injection of 99m Tc-DMSA. The study was performed using the dual type gamma camera. The renal function was assessed by the formula : 99m Tc-DMSA renal uptake of the operated side/ 99m Tc-DMSA renal uptake of the contralateral side. The change (ratio before/after PNL) x 100 was regarded as the percent change of renal function. Local abnormalities in the 99m Tc-DMSA renal scintigram after PNL were observed in 15 patients. The renal function decreased significantly to 95.8 ± 8.7 % from the base line 4 - 8 weeks after PNL. The renal function improved significantly to 98.6 ± 14.7 % from 92.1 ± 11.9 % in 12 patients about one year after PNL. It is concluded that although the renal function slightly decreased 4 - 8 weeks after PNL, it is expected to improve within 1 year after PNL. 99M Tc-DMSA scintigraphy is a useful adjunct to evaluate the renal function before and after PNL. (author)

Risk factors and co-morbidities associated with changes in renal function among antiretroviral treatment-naïve adults in South Africa: A chart review.

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Assaram, Shirelle; Mashamba-Thompson, Tivani P; Magula, Nombulelo P

2018-01-01

Our systematic scoping review has demonstrated a research gap in antiretroviral treatment (ART) nephrotoxicity as well as in the long-term outcomes of renal function for patients on ART in South Africa. Bearing in mind the high prevalence of human immunodeficiency virus (HIV) in South Africa, this is of great concern. To determine the risk factors and co-morbidities associated with changes in renal function in HIV-infected adults in South Africa. We conducted a retrospective study of 350 ART-naïve adult patients attending the King Edward VIII HIV clinic, Durban, South Africa. Data were collected at baseline (pre-ART) and at six, 12, 18 and 24 months on ART. Renal function was assessed in the 24-month period using the Modification of Diet in Renal Disease equation and was categorised into normal renal function (estimated glomerular filtration rate [eGFR] ≥ 60), moderate renal impairment (eGFR 30-59), severe renal impairment (eGFR 15-29) and kidney failure (eGFR 0.05. The vast majority of patients were initiated on tenofovir disoproxil fumarate (TDF) (90.6%), in combination with lamivudine (3TC) (100%) and either efavirenz (EFV) (56.6%) or nevirapine (NVP) (43.4%). This study reports a low prevalence of baseline renal impairment in HIV-infected ART-naïve outpatients. An improvement in renal function after the commencement of ART has been demonstrated in this population. However, the long-term outcomes of patients with HIV-related renal disease are not known.

Outcome and renal function following salvage surgery for bilateral ...

African Journals Online (AJOL)

Objective: The aim of this study was to determine the surgical outcomes and renal function following salvage surgery for bilateral Wilms tumor (BWT). Summary background data The challenge for the surgeon treating BWT lies in striking a fine balance between renal preservation and oncological clearance. Methods: This is ...

Renal function in streptozotocin-diabetic rats

DEFF Research Database (Denmark)

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

1981-01-01

to the rise in kidney glomerular filtration rate (diabetic rats: 37.0 nl/min; control rats: 27.9 nl/min). Likewise renal plasma flow was significantly higher in the diabetic rats (4.1 ml/min) than in the control group (3.0 ml/min). Glomerular capillary pressure was identical in both groups (56.0 and 56.0 mm......-1mmHg-1). Kidney weight was significantly higher in the diabetic rats (1.15 g; control rats: 0.96 g) while body weight was similar in both groups (diabetic rats: 232 g; control rats: 238 g). Calculations indicate that the increases in transglomerular hydraulic pressure, renal plasma flow......Renal function was examined with micropuncture methods in the insulin-treated streptozotocin-diabetic rat. Kidney glomerular filtration rate was significantly higher in the diabetic rats (1.21 ml/min) than in the control group (0.84 ml/min) Nephron glomerular filtration rate increased in proportion...

Renal imaging in paediatrics

International Nuclear Information System (INIS)

Porn, U.; Hahn, K.; Fischer, S.

2003-01-01

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.) [de

Long-term Renal Function in Living Kidney Donors Who Had Histological Abnormalities at Donation.

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Fahmy, Lara M; Massie, Allan B; Muzaale, Abimereki D; Bagnasco, Serena M; Orandi, Babak J; Alejo, Jennifer L; Boyarsky, Brian J; Anjum, Saad K; Montgomery, Robert A; Dagher, Nabil N; Segev, Dorry L

2016-06-01

Recent evidence suggests that living kidney donors are at an increased risk of end-stage renal disease. However, predicting which donors will have renal dysfunction remains challenging, particularly among those with no clinical evidence of disease at the time of donation. Although renal biopsies are not routinely performed as part of the donor evaluation process, they may yield valuable information that improves the ability to predict renal function in donors. We used implantation protocol biopsies to evaluate the association between histological abnormalities in the donated kidney and postdonation renal function (estimated glomerular filtration rate, eGFR) of the remaining kidney in living kidney donors. Longitudinal analysis using mixed-effects linear regression was used to account for multiple eGFR measures per donor. Among 310 donors between 1997 and 2012, median (IQR) follow-up was 6.2 (2.5-8.7; maximum 14.0) years. In this cohort, the overall prevalence of histological abnormalities was 65.8% (19.7% abnormal glomerulosclerosis, 23.9% abnormal interstitial fibrosis and tubular atrophy (IFTA), 4.8% abnormal mesangial matrix increase, 32.0% abnormal arteriolar hyalinosis, and 32.9% abnormal vascular intimal thickening). IFTA was associated with a 5-mL/min/1.73 m decrease of postdonation eGFR after adjusting for donor age at donation, sex, race, preoperative systolic blood pressure, preoperative eGFR, and time since donation (P < 0.01). In this single-center study, among healthy individuals cleared for living donation, IFTA was associated with decreased postdonation eGFR, whereas no other subclinical histological abnormalities provided additional information.

Effect of selective inhibition of renal inducible nitric oxide synthase on renal blood flow and function in experimental hyperdynamic sepsis.

Science.gov (United States)

Ishikawa, Ken; Calzavacca, Paolo; Bellomo, Rinaldo; Bailey, Michael; May, Clive N

2012-08-01

Nitric oxide plays an important role in the control of renal blood flow and renal function. In sepsis, increased levels of inducible nitric oxide synthase produce excessive nitric oxide, which may contribute to the development of acute kidney injury. We, therefore, examined the effects of intrarenal infusion of selective inducible nitric oxide synthase inhibitors in a large animal model of hyperdynamic sepsis in which acute kidney injury occurs in the presence of increased renal blood flow. Prospective crossover randomized controlled interventional studies. University-affiliated research institute. Twelve unilaterally nephrectomized Merino ewes. Infusion of a selective (1400W) and a partially selective inducible nitric oxide synthase inhibitor (aminoguanidine) into the renal artery for 2 hrs after the induction of sepsis, and comparison with a nonselective inhibitor (Nω-nitro-L-arginine methyl ester). In sheep with nonhypotensive hyperdynamic sepsis, creatinine clearance halved (32 to 16 mL/min, ratio [95% confidence interval] 0.51 [0.28-0.92]) despite increased renal blood flow (241 to 343 mL/min, difference [95% confidence interval] 102 [78-126]). Infusion of 1400W did not change renal blood flow, urine output, or creatinine clearance, whereas infusion of Nω-nitro-L-arginine methyl ester and a high dose of aminoguanidine normalized renal blood flow, but did not alter creatinine clearance. In hyperdynamic sepsis, intrarenal infusion of a highly selective inducible nitric oxide synthase inhibitor did not reduce the elevated renal blood flow or improve renal function. In contrast, renal blood flow was reduced by infusion of a nonselective NOS inhibitor or a high dose of a partially selective inducible nitric oxide synthase inhibitor. The renal vasodilatation in septic acute kidney injury may be due to nitric oxide derived from the endothelial and neural isoforms of nitric oxide synthase, but their blockade did not restore renal function.

Neural regulation of the kidney function in rats with cisplatin induced renal failure

Science.gov (United States)

Goulding, Niamh E.; Johns, Edward J.

2015-01-01

Aim: Chronic kidney disease (CKD) is often associated with a disturbed cardiovascular homeostasis. This investigation explored the role of the renal innervation in mediating deranged baroreflex control of renal sympathetic nerve activity (RSNA) and renal excretory function in cisplatin-induced renal failure. Methods: Rats were either intact or bilaterally renally denervated 4 days prior to receiving cisplatin (5 mg/kg i.p.) and entered a chronic metabolic study for 8 days. At day 8, other groups of rats were prepared for acute measurement of RSNA or renal function with either intact or denervated kidneys. Results: Following the cisplatin challenge, creatinine clearance was 50% lower while fractional sodium excretion and renal cortical and medullary TGF-β1 concentrations were 3–4 fold higher in both intact and renally denervated rats compared to control rats. In cisplatin-treated rats, the maximal gain of the high-pressure baroreflex curve was only 20% that of control rats, but following renal denervation not different from that of renally denervated control rats. Volume expansion reduced RSNA by 50% in control and in cisplatin-treated rats but only following bilateral renal denervation. The volume expansion mediated natriuresis/diuresis was absent in the cisplatin-treated rats but was normalized following renal denervation. Conclusions: Cisplatin-induced renal injury impaired renal function and caused a sympatho-excitation with blunting of high and low pressure baroreflex regulation of RSNA, which was dependent on the renal innervation. It is suggested that in man with CKD there is a dysregulation of the neural control of the kidney mediated by its sensory innervation. PMID:26175693

Renal function monitoring in heart failure - what is the optimal frequency? A narrative review.

Science.gov (United States)

Al-Naher, Ahmed; Wright, David; Devonald, Mark Alexander John; Pirmohamed, Munir

2018-01-01

The second most common cause of hospitalization due to adverse drug reactions in the UK is renal dysfunction due to diuretics, particularly in patients with heart failure, where diuretic therapy is a mainstay of treatment regimens. Therefore, the optimal frequency for monitoring renal function in these patients is an important consideration for preventing renal failure and hospitalization. This review looks at the current evidence for optimal monitoring practices of renal function in patients with heart failure according to national and international guidelines on the management of heart failure (AHA/NICE/ESC/SIGN). Current guidance of renal function monitoring is in large part based on expert opinion, with a lack of clinical studies that have specifically evaluated the optimal frequency of renal function monitoring in patients with heart failure. Furthermore, there is variability between guidelines, and recommendations are typically nonspecific. Safer prescribing of diuretics in combination with other antiheart failure treatments requires better evidence for frequency of renal function monitoring. We suggest developing more personalized monitoring rather than from the current medication-based guidance. Such flexible clinical guidelines could be implemented using intelligent clinical decision support systems. Personalized renal function monitoring would be more effective in preventing renal decline, rather than reacting to it. © 2017 The Authors. British Journal of Clinical Pharmacology published by John Wiley & Sons Ltd on behalf of British Pharmacological Society.

Renin-angiotenisn system polymorphisms and renal graft function in renal transplant recipients

International Nuclear Information System (INIS)

Argani, H.; Aghaeishahsavari, M.; Veisi, P.; Noorozianavval, M.; Asgarzadeh, M.; Hamzeiy, H.; Rashtchizadeh, N.; Ghorbanihaghjo, A.; Bonyadi, M.

2007-01-01

To analyze the role of 3 polymorphisms of the renin-angiotensisn system (RAS) in renal transplant recipient (RTRs) and correlate them with graft function. The present study was performed in the Drug Applied Research Center, Tabriz medical University, Tabriz, Iran from September 2003 to December 2005 on 108 RTRs (66 males and 42 females, with a mean age of 37.34+- 4.97 years) with stable allograft function (creatinine < 2.2 mg/dl). Following the DNA extraction from the blood leukocytes, the genotypes of the angiotenisn converting enzyme (ACE I/D), angiotensinogen (ANG M235T), and angiotensin II type 1 receptor (ATR1 A1166C) were determined by polymerase chain reaction. The magnitude of clearance of creatinine (ClCr) in the settling of each of the above RAS polymorphisms was determined. The ClCr was measured by modification of diet in renal disease formula. Values were expressed as mean +-SD; p<-0.05 was considered to indicate statistical significance. There was no association of each genotype of the RAS alone with ClCr, serum urea, cyclosporine through level and the degree of urinary protein excretion rate. However, patients with DD genotype of angiotensin converting enzyme + CC genotype of angiotensin II type I receptor polymorphisms had lower ClCr (p=0.05) and a higher urinary protein excretion rate (p=0.03). Other combination genotypes of RAS had no effect on allograft function. Interestingly, the percent of hypertensive patients in C allele (70%) was more than the A allele (30%) of ATR1 polymorphism (p=0.04). Although none of the single gene polymorphisms of the RAS affected renal allograft function, combinations of these genotypes were associated with outcome of allograft function. (author)

Renal Tubular Function in Systemic Lupus Erythematosus*

African Journals Online (AJOL)

immune' diseases such as. Sjogren's syndrome,'" systemic lupus erythematosus. (SLE),3 alveolitis' and chronic active hepatitis.' The reported abnormalities of renal tubular function include impairment of acid excretion and urinary concentration.

Changes in renal function after discontinuation of vitamin D analogues in advanced chronic kidney disease

Directory of Open Access Journals (Sweden)

Francisco Caravaca

2018-03-01

Full Text Available Background: In routine clinical practice, the prescription of vitamin D analogues (VDA in patients with chronic kidney disease (CKD is often associated with a decline of the estimated renal function. The reason for this is not fully understood. Aims: To analyze the effects of VDA discontinuation in advanced CKD and to determine the factors associated with changes in renal function. Material and methods: Retrospective cohort study of adult patients with advanced CKD. The case subgroup was treated with VDA and this medication was discontinued at baseline (the first visit. The control subgroup was not treated with VDA and they were selected according to comparability principles for CKD progression by propensity score matching. The primary outcome measure was a change to both the estimated glomerular filtration rate (MDRD-GFR and the measured glomerular filtration rate (mGFR by combined creatinine and urea clearances. Baseline parameters related to mineral metabolism and creatinine generation were analyzed as potential determinants of renal function changes. Results: The study sample consisted of 67 cases and 67 controls. Renal function improved in 67% of cases and worsened in 72% of controls (p < 0.0001. Changes in MDRD-GFR for the case subgroup and the control subgroup were +0.455 ± 0.997 vs. −0.436 ± 1.103 ml/min/1.73 m2/month (p < 0.0001, respectively. Total creatinine excretion was slightly higher in cases than in controls but the difference was not significant.According to multivariate logistic and linear regression analyses, baseline total serum calcium was one of the best determinants of both renal function recovery (Odds ratio = 3.49; p = 0.001, and of the extent of renal function recovery (beta = 0.276; p = 0.001. Conclusions: Discontinuation of VDA treatment in CKD patients is associated with significant recovery of estimated renal function. The extent of these changes is

Renal Blood Flow, Glomerular Filtration Rate, and Renal Oxygenation in Early Clinical Septic Shock.

Science.gov (United States)

Skytte Larsson, Jenny; Krumbholz, Vitus; Enskog, Anders; Bragadottir, Gudrun; Redfors, Bengt; Ricksten, Sven-Erik

2018-06-01

Data on renal hemodynamics, function, and oxygenation in early clinical septic shock are lacking. We therefore measured renal blood flow, glomerular filtration rate, renal oxygen consumption, and oxygenation in patients with early septic shock. Prospective comparative study. General and cardiothoracic ICUs. Patients with norepinephrine-dependent early septic shock (n = 8) were studied within 24 hours after arrival in the ICU and compared with postcardiac surgery patients without acute kidney injury (comparator group, n = 58). None. Data on systemic hemodynamics and renal variables were obtained during two 30-minute periods. Renal blood flow was measured by the infusion clearance of para-aminohippuric acid, corrected for renal extraction of para-aminohippuric acid. Renal filtration fraction was measured by renal extraction of chromium-51 labeled EDTA. Renal oxygenation was estimated from renal oxygen extraction. Renal oxygen delivery (-24%; p = 0.037) and the renal blood flow-to-cardiac index ratio (-21%; p = 0.018) were lower, renal vascular resistance was higher (26%; p = 0.027), whereas renal blood flow tended to be lower (-19%; p = 0.068) in the septic group. Glomerular filtration rate (-32%; p = 0.006) and renal sodium reabsorption (-29%; p = 0.014) were both lower in the septic group. Neither renal filtration fraction nor renal oxygen consumption differed significantly between groups. Renal oxygen extraction was significantly higher in the septic group (28%; p = 0.022). In the septic group, markers of tubular injury were elevated. In early clinical septic shock, renal function was lower, which was accompanied by renal vasoconstriction, a lower renal oxygen delivery, impaired renal oxygenation, and tubular sodium reabsorption at a high oxygen cost compared with controls.

Alteration of split renal function during Captopril treatment

International Nuclear Information System (INIS)

Aburano, Tamio; Takayama, Teruhiko; Nakajima, Kenichi; Tonami, Norihisa; Hisada, Kinichi; Yasuhara, Shuichirou; Miyamori, Isamu; Takeda, Ryoyu

1987-01-01

Two different methods to evaluate the alteration of split renal function following continued Captopril treatment were studied in a total of 21 patients with hypertension. Eight patients with renovascular hypertension (five with unilateral renal artery stenosis and three with bilateral renal artery stenoses), three patients with diabetic nephropathy, one patient with primary aldosteronism, and nine patients with essential hypertension were included. The studies were performed the day prior to receiving Captopril (baseline), and 6th or 7th day following continued Captopril treatment (37.5 mg or 75 mg/day). Split effective renal plasma flow (ERPF) and glomerular filtration rate (GFR) after injections of I-131 hippuran and Tc-99m DTPA were measured using kidney counting corrected for depth and dose, described by Schlegel and Gates. In the patients with renovascular hypertension, split GFR in the stenotic kidney was significantly decreased 6th or 7th day following continued Captopril treatment compared to a baseline value. And split ERPF in the stenotic kidney was slightly increased although significant increase of split ERPF was not shown. In the patients with diabetic nephropathy, primary aldosteronism or essential hypertension, on the other hand, split GFR was not changed and split ERPF was slightly increased. These findings suggest that the Captopril induced alterations of split renal function may be of importance for the diagnosis of renovascular hypertension. For this purpose, split GFR determination is more useful than split ERPF determination. (author)

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

International Nuclear Information System (INIS)

Preda, Lorenzo; Agazzi, Alberto; Martinelli, Giovanni; Raimondi, Sara; Lanfranchi, Carla Federica; Passerini, Rita; Calvetta, Albania; Bellomi, Massimo

2011-01-01

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

MRI estimation of total renal volume demonstrates significant association with healthy donor weight

International Nuclear Information System (INIS)

Cohen, Emil I.; Kelly, Sarah A.; Edye, Michael; Mitty, Harold A.; Bromberg, Jonathan S.

2009-01-01

Purpose: The purpose of this study was to correlate total renal volume (TRV) calculations, obtained through the voxel-count method and ellipsoid formula with various physical characteristics. Materials and methods: MRI reports and physical examination from 210 healthy kidney donors (420 kidneys), on whom renal volumes were obtained using the voxel-count method, were retrospectively reviewed. These values along with ones obtained through a more traditional method (ellipsoid formula) were correlated with subject height, body weight, body mass index (BMI), and age. Results: TRV correlated strongly with body weight (r = 0.7) and to a lesser degree with height, age, or BMI (r = 0.5, -0.2, 0.3, respectively). The left kidney volume was greater than the right, on average (p < 0.001). The ellipsoid formula method over-estimated renal volume by 17% on average which was significant (p < 0.001). Conclusions: Body weight was the physical characteristic which demonstrated the strongest correlation with renal volume in healthy subjects. Given this finding, a formula was derived for estimating the TRV for a given patient based on the his or her weight: TRV = 2.96 x weight (kg) + 113 ± 64.

Radiologic imaging of the renal parenchyma structure and function.

Science.gov (United States)

Grenier, Nicolas; Merville, Pierre; Combe, Christian

2016-06-01

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

Embryonic kidney function in a chronic renal failure model in rodents.

Science.gov (United States)

Fujimoto, Eisuke; Yamanaka, Shuichiro; Kurihara, Sho; Tajiri, Susumu; Izuhara, Luna; Katsuoka, Yuichi; Yokote, Shinya; Matsumoto, Kei; Kobayashi, Eiji; Okano, Hirotaka James; Chikaraishi, Tatsuya; Yokoo, Takashi

2017-08-01

Rapid advancements have been made in alternative treatments for renal diseases. Our goal for renal regeneration is to establish a kidney graft derived from human embryonic tissues. In this study, we investigated the effects of host renal failure on the structure and activity of transplanted embryonic kidney and bladder, and found that diuretics effectively induced urine production in the transplanted kidney. Uremic conditions were reproduced using a 5/6 renal infarction rat model. An embryonic kidney plus bladder (embryonic day 15) was isolated from a pregnant Lewis rat and transplanted into the para-aortic area of a 5/6 renal-infarcted Lewis rat. Following growth, the embryonic bladder was successfully anastomosed to the host ureter. We assessed graft function in terms of survival rates and found no differences between normal (n = 5) and renal failure (n = 8) groups (median survival: 70.5 vs 74.5 h; p = 0.331) in terms of survival, indicating that the grafts prolonged rat survival, even under renal failure conditions. Furosemide (n = 9) significantly increased urine volume compared with saline-treated controls (n = 7; p < 0.05), confirming that the grafts were functional. We also demonstrated the possibilities of an in vivo imaging system for determining the viability of transplanted embryonic kidney with bladder. The results of this study demonstrate that transplanted embryonic kidney and bladder can grow and function effectively, even under uremic conditions.

Predicting kidney graft failure using time-dependent renal function covariates

NARCIS (Netherlands)

de Bruijne, Mattheus H. J.; Sijpkens, Yvo W. J.; Paul, Leendert C.; Westendorp, Rudi G. J.; van Houwelingen, Hans C.; Zwinderman, Aeilko H.

2003-01-01

Chronic rejection and recurrent disease are the major causes of late graft failure in renal transplantation. To assess outcome, most researchers use Cox proportional hazard analysis with time-fixed covariates. We developed a model adding time-dependent renal function covariates to improve the

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....

Functional MR urography in patients with renal transplants

International Nuclear Information System (INIS)

Knopp, M.V.; Doersam, J.; Oesingmann, N.; Piesche, S.; Hawighorst, H.; Wiesel, M.; Schad, L.R.; Kaick, G. van

1997-01-01

Purpose: To assess the value of functional magnetic resonance urography for the noninvasive postoperative evaluation of renal transplants. Methods: A saturation inversion projection sequence allows the selective imaging of strongly T1 weighted signal from the MR contrast agent. A coronal slab leads to images comparable to conventional urography which can be acquired as a sequence with four images per minute. Results: 15 patients with urologic questionable findings after renal transplantation were studied. FMRU revealed in 6 patients normal findings, in 6 moderate dilatation of the renal pelvis without any urodynamic relevant obstruction. 3 pathologic findings, ureteral leak, ureteropelvic-junction obstruction and ureteral stenosis were diagnosed and consequently surgically treated. The imaging quality in all studies was diagnostic and urologically relevant. Conclusion: FMRU can be used as a noninvasive technique for the assessment of renal transplant in cases with suspicion of complication in the excretory system. (orig.) [de

Renal dynamic functional scintigraphy in children with congenital urinary tract anomalies

International Nuclear Information System (INIS)

Cui Ruixue; Zhou Qian

2000-01-01

Objective: To clarify the characteristics of renal scintigraphy in children with various congenital urinary tract anomalies and to evaluate their clinical significance. Methods: 51 children with congenital urinary tract anomalies were studied by 99 Tc m -DTPA renal dynamic functional scintigraphy (RDFS)). Among them, 8 cases were studied by diuretic renography in addition. Results: RDFS provided: 1) Both the morphological information of anomalies and the split renal function. 2) Localization of the site of urinary tract obstruction. In case of pelviureteric junction obstruction, the hydronephrosis was usually severe but with normal size ureter, whereas in ureterovesical junction obstruction the hydronephrosis was less severe but with dilatation of ureter. In case of lower urinary tract obstruction, the hydronephrosis and hydroureter were bilateral. Diuretic renography differentiated obstructive from non-obstructive hydronephrosis. By comparing pre-and post operative studies, it was easy to evaluate the recovery of renal function. Conclusions: RDFS is a valuable modality for giving both anatomical and functional information in children with congenital urinary tract anomalies and the authors suggest it should be used more popularly in Pediatrics

Examination of the renal function during the first half of pregnancy

International Nuclear Information System (INIS)

Voigt, R.; Stoll, W.

1980-01-01

The renal function of 25 women in the first half of pregnancy was examined by means of sequence scintigrams of the kidneys and by the results of 131 I-hippurate clearance. Up to the 17th week of pregnancy a continuous increase of the clearance equivalents existed. In comparison to non-pregnant women no important changes were observed on the right and on the left above both the ROI of the renal parenchyma and of the renal pelvis. Problems referring to the clearance of paraaminohippuric acid, which is tubularly excreted like 131 I-hippurate, were discussed. Despite of the good suitability of radionuclide methods for screening of the renal function, they should not be applied in early pregnancy because of radioprotective reasons

The Renal Arterial Resistance Index Predicts Worsening Renal Function in Chronic Heart Failure Patients

Science.gov (United States)

Iacoviello, Massimo; Monitillo, Francesco; Leone, Marta; Citarelli, Gaetano; Doronzo, Annalisa; Antoncecchi, Valeria; Puzzovivo, Agata; Rizzo, Caterina; Lattarulo, Maria Silvia; Massari, Francesco; Caldarola, Pasquale; Ciccone, Marco Matteo

2016-01-01

Background/Aim The renal arterial resistance index (RRI) is a Doppler measure, which reflects abnormalities in the renal blood flow. The aim of this study was to verify the value of RRI as a predictor of worsening renal function (WRF) in a group of chronic heart failure (CHF) outpatients. Methods We enrolled 266 patients in stable clinical conditions and on conventional therapy. Peak systolic velocity and end diastolic velocity of a segmental renal artery were obtained by pulsed Doppler flow, and RRI was calculated. Creatinine serum levels were evaluated at baseline and at 1 year, and the changes were used to assess WRF occurrence. Results During follow-up, 34 (13%) patients showed WRF. RRI was associated with WRF at univariate (OR: 1.13; 95% CI: 1.07–1.20) as well as at a forward stepwise multivariate logistic regression analysis (OR: 1.09; 95% CI: 1.03–1.16; p = 0.005) including the other univariate predictors. Conclusions Quantification of arterial renal perfusion provides a new parameter that independently predicts the WRF in CHF outpatients. Its possible role in current clinical practice to better define the risk of cardiorenal syndrome progression is strengthened. PMID:27994601

Validity of estimated prevalence of decreased kidney function and renal replacement therapy from primary care electronic health records compared with national survey and registry data in the United Kingdom.

Science.gov (United States)

Iwagami, Masao; Tomlinson, Laurie A; Mansfield, Kathryn E; Casula, Anna; Caskey, Fergus J; Aitken, Grant; Fraser, Simon D S; Roderick, Paul J; Nitsch, Dorothea

2017-04-01

Anonymous primary care records are an important resource for observational studies. However, their external validity is unknown in identifying the prevalence of decreased kidney function and renal replacement therapy (RRT). We thus compared the prevalence of decreased kidney function and RRT in the Clinical Practice Research Datalink (CPRD) with a nationally representative survey and national registry. Among all people ≥25 years of age registered in the CPRD for ≥1 year on 31 March 2014, we identified patients with an estimated glomerular filtration rate (eGFR) primary care data have good external validity for the prevalence of decreased kidney function and RRT. © The Author 2017. Published by Oxford University Press on behalf of ERA-EDTA.

Evaluation of Renal Function in Children by Tc-99m DTPA Scintigraphy

Directory of Open Access Journals (Sweden)

Sevin Ayaz

2016-09-01

Full Text Available Aim: Dynamic renal scintigraphy can demonstrate both structural and functional renal pathologies. Our aim was to evaluate renal functions in children by technetium-99m diethylenetriaminepentaacetic acid (Tc-99m DTPA dynamic renal scintigraphy, and todetermine the frequency of scintigraphically detectable atrophic kidneys. Material and Method: Dynamic renal scintigraphy studies of 17 children (12 males, five females with urinary system complaints, having a mean age of 6.15 ± 4.41 years, were included in this retrospective study. Images were obtained with a dual-head gamma camera after intravenous (IV injection of Tc-99m DTPA. Results: The functions of 34 kidneys were evaluated. Decreased perfusion of the left and right kidneys was detected in 35.3% (n=6/17 and 11.8% (n=2/17 of cases, respectively. Prolongation in Tmax of the left and right kidneys was shown in 52.9% (n=9/17 and 29.4% (n=5/17 of the cases, respectively. Glomerular filtration rate of the left and right kidneys was normal in 64.7% (n=11/17 and 88.2% (n=15/17 of cases, respectively. Delayed excretion of the left and right kidneys wasdetected in 29.4% (n=5/17 and 11.8% (n=2/17 of cases, respectively. Stasis of urine in the left and right kidneys which responded to IV diuretics wasdemonstrated in 58.8% (n=10/17 and 70.6% (n=12/17 of cases, respectively. Dynamic renal scintigraphy findings in favour of left and right renal atrophy were obtained in 17.6% (n=3/17 and 5.9% (n=1/17 of cases, respectively. Discussion: Dynamic renal scintigraphy with Tc-99m DTPA was found to be useful in the evaluation of renal functions of children and in determining the frequency of atrophic kidneys.

Vascular and renal function in experimental thyroid disorders.

Science.gov (United States)

Vargas, Félix; Moreno, Juan Manuel; Rodríguez-Gómez, Isabel; Wangensteen, Rosemary; Osuna, Antonio; Alvarez-Guerra, Miriam; García-Estañ, Joaquín

2006-02-01

This review focuses on the effects of thyroid hormones in vascular and renal systems. Special emphasis is given to the mechanisms by which thyroid hormones affect the regulation of body fluids, vascular resistance and, ultimately, blood pressure. Vascular function is markedly affected by thyroid hormones that produce changes in vascular reactivity and endothelial function in hyper- and hypothyroidism. The hypothyroid state is accompanied by a marked decrease in sensitivity to vasoconstrictors, especially to sympathetic agonists, alteration that may play a role in the reduced blood pressure of hypothyroid rats, as well as in the preventive effects of hypothyroidism on experimental hypertension. Moreover, in hypothyroid rats, the endothelium-dependent and nitric oxide donors vasodilation is reduced. Conversely, the vessels from hyperthyroid rats showed an increased endothelium-dependent responsiveness that may be secondary to the shear-stress induced by the hyperdynamic circulation, and that may contribute to the reduced vascular resistance characteristic of this disease. Thyroid hormones also have important effects in the kidney, affecting renal growth, renal haemodynamics, and salt and water metabolism. In hyperthyroidism, there is a resetting of the pressure-natriuresis relationship related to hyperactivity of the renin-angiotensin system, which contributes to the arterial hypertension associated with this endocrine disease. Moreover, thyroid hormones affect the development and/or maintenance of various forms of arterial hypertension. This review also describes recent advances in our understanding of thyroid hormone action on nitric oxide and oxidative stress in the regulation of cardiovascular and renal function and in the long-term control of blood pressure.

Studies on the evaluation of renal function in urological renal disorders with 99mTc-DMSA renal uptake, 1

International Nuclear Information System (INIS)

Takeda, Masayuki

1987-01-01

The change of normal value of 99m Tc-dimercaptosuccinic acid (DMSA) renal uptake with age was investigated, and the correlation between total renal uptake of 99m Tc-DMSA and 24-hour endogenous creatinine clearance was studied in each age group separately. (1) 99m Tc-DMSA renal uptake was measured in 107 normal controls without renal or urinary tract diseases between 0 and 67 years old and normal values were analyzed in each age group. The normal value was highest in the age group of 0 ∼ 9 years old and was gradually decreased with age. Over 20 years old, the normal value hardly changed. (2) The lower limit of normal values of 99m Tc-DMSA renal uptake in each kidney was 19.62, 13.89, 13.18, 11.58, 12.00, 10.24 % in the age groups of 0 ∼ 9, 10 ∼ 19, 20 ∼ 29, 30 ∼ 39, 40 ∼ 49, 50 ∼ 59 years old, respectively. (3) Correlations between total renal uptake and 24-hour endogenous creatinine clearance were investigated in each age group in 248 patients between 0 and 79 years old. Positive linear correlations were found in the age groups of 0 ∼ 9, 10 ∼ 19, 20 ∼ 29, 30 ∼ 39, 40 ∼ 49, 50 ∼ 59, 60 ∼ 69, 70 ∼ 79 years old, and especially above 50 years old closer correlations were found. It is concluded that although 99m Tc-DMSA renal uptake is a useful method for renal function test through life, the change with age must be considered in the evaluation of its value. (author)

Functional effects of renal artery stent placement on treated and contralateral kidneys.

NARCIS (Netherlands)

Leertouwer, T.C.; Derkx, F.H.M.; Pattynama, P.M.; Deinum, J.; Dijk, L.C. van; Schalekamp, M.A.D.H.

2002-01-01

BACKGROUND: This study examined the effects of stent placement for renal artery stenosis on the function of treated and contralateral kidneys. METHODS: Eighteen patients who underwent stent placement for unilateral renal artery stenosis presenting with hypertension and/or renal failure were studied

Successful renal transplantation from a brain-dead deceased donor with head injury, disseminated intravascular coagulation and deranged renal functions

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P P Ghuge

2013-01-01

Full Text Available Deceased donors (DDs with the brain death due to head injury are the major source of organs for transplantation. The incidence of post-head injury disseminated intravascular coagulation (DIC ranges from 24% to 50%. Many centers do not accept organs from donors with DIC due to increased risk of primary graft non-function and/or high chances of morbidity/mortality. We performed two successful renal transplants from a DD with head injury with DIC and deranged renal function. One of the recipients developed transient thrombocytopenia, but there was no evidence of DIC or delayed graft functions in either of the recipients. Over a follow-up of 1 month, both are doing well with stable graft function and hematological profile. Thus, a carefully selected DD with severe DIC even with deranged renal function is not a contraindication for organ donation if other risk factors for primary non-function are excluded. This approach will also help in overcoming organ shortage.

Osseous metastases from renal cell carcinoma: embolization and surgery for restoration of function. Work in progress

International Nuclear Information System (INIS)

Rowe, D.M.; Becker, G.J.; Rabe, F.E.; Holden, R.W.; Richmond, B.D.; Wass, J.L.; Sequeira, F.W.

1984-01-01

Five patients underwent preoperative embolization of osseous metastases from renal cell carcinoma. The group consisted of four men and one woman who ranged in age from 46 to 79 years. The lesions were located in the pubic ramus and acetabulum, proximal femur, femoral midshaft, proximal humerus, and proximal tibia. All embolizations were performed within 24 hours of surgery. The internal fixation and tumor curettage was accomplished with estimated perioperative blood loss ranging from 10 ml to 1,250 ml. All patients had significant restoration of function following surgery. The authors suggest that preoperative embolization is an important and efficacious adjunct in the management of hypervascular renal cell osseous metastases

Effect of large weight reductions on measured and estimated kidney function

DEFF Research Database (Denmark)

von Scholten, Bernt Johan; Persson, Frederik; Svane, Maria S

2017-01-01

GFR (creatinine-based equations), whereas measured GFR (mGFR) and cystatin C-based eGFR would be unaffected if adjusted for body surface area. METHODS: Prospective, intervention study including 19 patients. All attended a baseline visit before gastric bypass surgery followed by a visit six months post-surgery. m...... for body surface area was unchanged. Estimates of GFR based on creatinine overestimate renal function likely due to changes in muscle mass, whereas cystatin C based estimates are unaffected. TRIAL REGISTRATION: ClinicalTrials.gov, NCT02138565 . Date of registration: March 24, 2014....

[Anatomy character of renal artery and treatment of living-donor renal transplantation].

Science.gov (United States)

Zhang, Lei; Fei, Ji-guang; Chen, Li-zhong; Wang, Chang-xi; Deng, Su-xiong; Qiu, Jiang; Li, Jun; Chen, Guo-dong; Huang, Gang

2009-12-15

To study the anatomy characters of renal artery and the treatment of multiple arteries in living donor renal grafts. Records of 142 living donors were analyzed in our center. We analyzed the anatomic structure of renal arteries by DSA and CTA pre-transplantation. Thirty-one kidneys with multiple arteries were transplanted after reconstruction. Then clinical effects were compared between multiple-renal-arteries group (n=31) and single-renal-artery group (n=111). The incidence of multiple renal artery was 30.99%, and there was no difference between both sides (left kidney 22.54%, right kidney 22.13%). If the multiple artery occurred in left or right kidney, the incidence of the multiple artery occurred in the other side was 56.25% and 60.00%, respectively. The diameter of left main renal artery was more magnanimous (P=0.001) and the first branch was more closed to abdominal aorta (P=0.004). Operation time and warm/cool ischemia time were longer in the multiple-renal-arteries group. However, estimated blood loss, delayed graft function, acute rejection and flow rate of arcuate artery were similar in both groups, the same as serum creatinine and serum creatinine clearance rate on day 7, 1 month and 3 month post-operation. It was shown by repeated measures ANOVA that graft with multiple arteries didn't affect the tendency of renal function at early time post-operation. Comprehending the character of renal artery and accurate treatment of multiple artery anastomosis are critical for the effect of the living kidney transplantation.

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

International Nuclear Information System (INIS)

Chen Yueguang; Lv Baojing

2006-01-01

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

Evaluation of renal transplant perfusion by functional imaging

International Nuclear Information System (INIS)

Nicoletti, R.

1990-01-01

Radionuclide angiography (RNA) is used as a noninvasive method for the evaluation of renal transplant perfusion. The computer processing method generally used, based on regions of interest, is unsatisfactory because it does not permit the regional differentiation of perfusion defects. Furthermore, the subjective delineation of the regions of interest introduces considerable inter-observer variation of results. We developed a processing method which is less operator-dependent and permits the evaluation of local defects; it is based on the concept of functional imaging. The method was evaluated in 62 patient examinations, which were subdivided into four groups: Normal transplant perfusion (23 examinations), acute tubular necrose (ATN) (16), cellular rejection (13), and vascular rejection (10). Quantitative results derived from profile curves were combined with visual estimation of the functional images and yielded a synoptic graph which allowed differentiation into three groups: Normal transplant perfusion (sensitivity 0.78, specificity 0.97), ATN or cellular rejection (sens. 0.83, spec. 0.82), and vascular rejection (sens. 0.90, spec. 0.92). (orig.)

The effects of acebutolol and atenolol on renal function in patients with chronic renal failure and hypertension

International Nuclear Information System (INIS)

Lustig, A.

1985-03-01

The present study determined the effects of chronic administration of acebutolol and atenolol on renal function 22 patients suffering from chronic renal failure (mean GFR of 33.7 +- 4.0 ml/min) and hypertension. Renal function and systemic haemodynamics were measured after 2 weeks of placebo treatment, after 6 weeks of oral acebutolol therapy (200 - 400 mg/day) and after 6 weeks of atenolol therapy (50 - 100 mg/day). The GFR assessed by 51 Cr EDTA clearance fell by 9.4 +- 7.4% on acebutolol therapy and 7.9 +- 7.0% on atenolol therapy. The renal blood flow assessed by 131 I-Hippuran clearance increased by 18.1 +- 6.1% on atenolol (P 0.05). Blood urea rose significantly on both agents. Both agents were found to be effective in reducing the mean arterial pressure in the supine or in the standing positions. No significant differences were found regarding their effects on renal function. Atenolol was more effective than acebutolol in reducing the heart rate. Plasma drug levels were measured. The combined levels of acebutolol and diacetolol were in the recommended therapeutic window (0.2 - 2.0 μg/ml) in 16 patients receiving acebutolol and in excess of this in 5 patients. Atenolol levels were in the recommended therapeutic window (0.1 - 1.0 μg/ml) in 10 patients and in excess of this in 10 patients. The alterations in the various parameters induced by the beta blockers in patients with GFR of less than 30 ml/min were similar to those induced in the patients who had GFR of over 30 ml/min. In conclusion: despite effective drop of blood pressure and heart rate induced by acebutolol and atenolol, these agents did not reduce the RBF and the fall in GFR noted was small magnitude and of no clinical significance. These two beta blockers may be used in patients with CRF provided caution is exercised and renal function is monitored regularly

Renal Function Studies with a Scintillation Camera

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Farmelant, M. H.; Genna, S.; Burrows, B. A. [University Hospital and Boston Veterans Administration Hospital, Boston, MA (United States)

1969-05-15

Renal function studies with {sup 131}I-Hippuran have usually been performed with two probes, with flat field collimators, of which the sensitivity is dependent on kidney position. Although a variety of methods have been used to interpret the results, it is almost universally agreed that the relative magnitudes of the curves obtained during the accumulation phase are determined by both the relative blood flow and relative geometrical efficiency of counting. The relative influence of these two factors is not easily ascertained. Because of this limitation in directly assessing relative renal blood flow indirect methods have evolved. From physiological studies in dogs it appears that differences between the kidneys in blood flow produce differences in renal passage time and subsequently differences in the descending portions of the curves. Evaluation of differences in the descending curves in patients has proved highly sensitive in detecting renal vascular disease causing hypertension. However, obstructive disorders of urine outflow also produce alterations in the declining portion of the curve. A scintillation camera provides a detector considerably larger than the kidney and uses parallel hole collimation. This arrangement results in count-rates that are largely independent of kidney position, as shown by phantom studies. Furthermore, sequential scintigraphs can be obtained. Using the Pho-Gamma III (Nuclear Chicago) with 'split' crystal for clinical studies, we have demonstrated that the relative uptake of {sup 131}I-Hippuran by the two kidneys during the accumulation phase differs by less than 15% in normal people. These differences may be related to differences in kidney size or blood flow. Differences greater than this suggest significant differences between the kidneys in renal blood flow if the scintigrams show kidneys of comparable size. The sequential scintigrams have proven to be accurate in differentiating retention of radioisotope due to vascular disease

Developmental Programming of Renal Function and Re-Programming Approaches.

Science.gov (United States)

Nüsken, Eva; Dötsch, Jörg; Weber, Lutz T; Nüsken, Kai-Dietrich

2018-01-01

Chronic kidney disease affects more than 10% of the population. Programming studies have examined the interrelationship between environmental factors in early life and differences in morbidity and mortality between individuals. A number of important principles has been identified, namely permanent structural modifications of organs and cells, long-lasting adjustments of endocrine regulatory circuits, as well as altered gene transcription. Risk factors include intrauterine deficiencies by disturbed placental function or maternal malnutrition, prematurity, intrauterine and postnatal stress, intrauterine and postnatal overnutrition, as well as dietary dysbalances in postnatal life. This mini-review discusses critical developmental periods and long-term sequelae of renal programming in humans and presents studies examining the underlying mechanisms as well as interventional approaches to "re-program" renal susceptibility toward disease. Clinical manifestations of programmed kidney disease include arterial hypertension, proteinuria, aggravation of inflammatory glomerular disease, and loss of kidney function. Nephron number, regulation of the renin-angiotensin-aldosterone system, renal sodium transport, vasomotor and endothelial function, myogenic response, and tubuloglomerular feedback have been identified as being vulnerable to environmental factors. Oxidative stress levels, metabolic pathways, including insulin, leptin, steroids, and arachidonic acid, DNA methylation, and histone configuration may be significantly altered by adverse environmental conditions. Studies on re-programming interventions focused on dietary or anti-oxidative approaches so far. Further studies that broaden our understanding of renal programming mechanisms are needed to ultimately develop preventive strategies. Targeted re-programming interventions in animal models focusing on known mechanisms will contribute to new concepts which finally will have to be translated to human application. Early

Developmental Programming of Renal Function and Re-Programming Approaches

Science.gov (United States)

Nüsken, Eva; Dötsch, Jörg; Weber, Lutz T.; Nüsken, Kai-Dietrich

2018-01-01

Chronic kidney disease affects more than 10% of the population. Programming studies have examined the interrelationship between environmental factors in early life and differences in morbidity and mortality between individuals. A number of important principles has been identified, namely permanent structural modifications of organs and cells, long-lasting adjustments of endocrine regulatory circuits, as well as altered gene transcription. Risk factors include intrauterine deficiencies by disturbed placental function or maternal malnutrition, prematurity, intrauterine and postnatal stress, intrauterine and postnatal overnutrition, as well as dietary dysbalances in postnatal life. This mini-review discusses critical developmental periods and long-term sequelae of renal programming in humans and presents studies examining the underlying mechanisms as well as interventional approaches to “re-program” renal susceptibility toward disease. Clinical manifestations of programmed kidney disease include arterial hypertension, proteinuria, aggravation of inflammatory glomerular disease, and loss of kidney function. Nephron number, regulation of the renin–angiotensin–aldosterone system, renal sodium transport, vasomotor and endothelial function, myogenic response, and tubuloglomerular feedback have been identified as being vulnerable to environmental factors. Oxidative stress levels, metabolic pathways, including insulin, leptin, steroids, and arachidonic acid, DNA methylation, and histone configuration may be significantly altered by adverse environmental conditions. Studies on re-programming interventions focused on dietary or anti-oxidative approaches so far. Further studies that broaden our understanding of renal programming mechanisms are needed to ultimately develop preventive strategies. Targeted re-programming interventions in animal models focusing on known mechanisms will contribute to new concepts which finally will have to be translated to human application

Dynamic 18F-fluoride small animal PET to noninvasively assess renal function in rats

International Nuclear Information System (INIS)

Schnoeckel, Uta; Stegger, Lars; Schaefers, Klaus P.; Hermann, Sven; Schober, Otmar; Schaefers, Michael; Reuter, Stefan; Schlatter, Eberhard; Gabriels, Gert

2008-01-01

Renal function can be quantified by both laboratory and scintigraphic methods. In the case of small animal diagnostics, scintigraphic image-based methods are ideal since they can assess split renal function, work noninvasively, and can be repeated. The aim of this study is to validate a 18 F-PET-based method to quantify renal function in rats. Fluoride clearance was calculated from a dynamic whole body listmode acquisition of 60 min length in a small animal PET scanner following an i.v. injection of 15 MBq 18 F-fluoride. Volumes of interest (VOIs) were placed in the left ventricle and the bladder as well as traced around the kidney contours. The respective time-activity curves (TAC) were calculated. The renal 18 F-clearance was calculated by the ratio of the total renal excreted activity (bladder VOI) and the integral of the blood TAC. PET-derived renal function was validated by intraindividual measurements of creatinine clearance (n=23), urea clearance (n=23), and tubular excretion rate (TER-MAG3). The split renal function was derived from the injection of the clinically available radionuclide 99m Tc-mercaptotriglycine by blood sampling and planar renography (n=8). In all animals studied, PET revealed high-quality TACs. PET-derived renal fluoride clearance was linearly correlated with intraindividual laboratory measures (PET vs. creatinine: r=0.78; PET vs. urea: r=0.73; PET vs. TER-MAG3: r=0.73). Split function was comparable ( 18 F-PET vs. MAG3-renography: r=0.98). PET-derived measures were highly reproducible. 18 F-PET is able to noninvasively assess renal function in rats and provides a significant potential for serial studies in different experimental scenarios. (orig.)

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

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Etienne Macedo

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

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

International Nuclear Information System (INIS)

Raynaud, C.; Ricard, S.; Knipper, M.

1977-01-01

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

Radionuclide assessment of renal function in patients with oncogynecological diseases

International Nuclear Information System (INIS)

Vlakhov, N.; Penkova, D.; Kovachev, A.

1989-01-01

Results of 131 I-hippuran (0.74 MBq) nephrography and 99m Tc DMCA (55.6 MBq) scintigraphy of the kidneys in 204 women from 21 to 75 years of age are analyzed. All patients were examined before and after treatment (surgical, radiation, hormonal). It was found that combined radiotherapy of patients with cervix uteri cancer and surgical treatment of patients with corpus uteri cancer resulted in aggravation of the secretory and excretory renal disorders, as compared to the pre-treatment state. It was not until after the second year of treatment that normal renal function was reestablished. Radionuclide methods furnish the opportunity both for early detection of renal function disorders and for their dynamic control and treatment. 1 tab., 4 refs

Effects of dietary lipids on renal function of aged rats

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Valente Gamba C.

2001-01-01

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

Assessment of renal function with the Tc-99m-MAG3 clearance

International Nuclear Information System (INIS)

Keske, U.; Corcles, M.; Andreessen, R.; Wilfling, M.; Roll, D.; Gahl, G.; Felix, R.

1990-01-01

This paper evaluates the applicability of the 99m-Tc-mercaptoacetyle-triglycine (MAG3) clearance for the documentation of renal function. Renal clearance was measured with the method of Tauxe in 699 patients during routine renal scintigraphy with 80 MBq of 99mTc-MAG3. Serum creatinine level and MAG3 clearance show an inverse correlation. Patients with an elevated serum creatinine level constantly have a lowered MAG3 clearance and vice versa. For creatinine values lower than 1.8 mg/dL, minor changes in creatinine level are accompanied by large changes in MAG3 clearance. Age (in years) dependence of MAG3 clearance was evaluated in 487 patients who showed no evidence of impaired renal function

Vascular calcification and cardiac function according to residual renal function in patients on hemodialysis with urination.

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Dong Ho Shin

Full Text Available Vascular calcification is common and may affect cardiac function in patients with end-stage renal disease (ESRD. However, little is known about the effect of residual renal function on vascular calcification and cardiac function in patients on hemodialysis.This study was conducted between January 2014 and January 2017. One hundred six patients with residual renal function on maintenance hemodialysis for 3 months were recruited. We used residual renal urea clearance (KRU to measure residual renal function. First, abdominal aortic calcification score (AACS and brachial-ankle pulse wave velocity (baPWV were measured in patients on hemodialysis. Second, we performed echocardiography and investigated new cardiovascular events after study enrollment.The median KRU was 0.9 (0.3-2.5 mL/min/1.73m2. AACS (4.0 [1.0-10.0] vs. 3.0 [0.0-8.0], p = 0.05 and baPWV (1836.1 ± 250.4 vs. 1676.8 ± 311.0 cm/s, p = 0.01 were significantly higher in patients with a KRU < 0.9 mL/min/1.73m2 than a KRU ≥ 0.9 mL/min/1.73m2. Log-KRU significantly negatively correlated with log-AACS (ß = -0.29, p = 0.002 and baPWV (ß = -0.19, P = 0.05 after factor adjustment. The proportion of left ventricular diastolic dysfunction was significantly higher in patients with a KRU < 0.9 mL/min/1.73m2 than with a KRU ≥ 0.9 mL/min/1.73m2 (67.9% vs. 49.1%, p = 0.05. Patients with a KRU < 0.9 mL/min/1.73m2 showed a higher tendency of cumulative cardiovascular events compared to those with a KRU ≥ 0.9 ml/min/1.73m2 (P = 0.08.Residual renal function was significantly associated with vascular calcification and left ventricular diastolic dysfunction in patients on hemodialysis.

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

DEFF Research Database (Denmark)

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

1987-01-01

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

Radionuclide assessment of renal function in the transplanted kidney

International Nuclear Information System (INIS)

Kawasaki, Yukiko; Maki, Masako; Nara, Shigeko; Hiroe, Michiaki; Kusakabe, Kiyoko; Shigeta, Akiko; Toma, Hiroshi; Kohno, Hiroko

1985-01-01

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

Developmental Programming of Renal Function and Re-Programming Approaches

Directory of Open Access Journals (Sweden)

Eva Nüsken

2018-02-01

Full Text Available Chronic kidney disease affects more than 10% of the population. Programming studies have examined the interrelationship between environmental factors in early life and differences in morbidity and mortality between individuals. A number of important principles has been identified, namely permanent structural modifications of organs and cells, long-lasting adjustments of endocrine regulatory circuits, as well as altered gene transcription. Risk factors include intrauterine deficiencies by disturbed placental function or maternal malnutrition, prematurity, intrauterine and postnatal stress, intrauterine and postnatal overnutrition, as well as dietary dysbalances in postnatal life. This mini-review discusses critical developmental periods and long-term sequelae of renal programming in humans and presents studies examining the underlying mechanisms as well as interventional approaches to “re-program” renal susceptibility toward disease. Clinical manifestations of programmed kidney disease include arterial hypertension, proteinuria, aggravation of inflammatory glomerular disease, and loss of kidney function. Nephron number, regulation of the renin–angiotensin–aldosterone system, renal sodium transport, vasomotor and endothelial function, myogenic response, and tubuloglomerular feedback have been identified as being vulnerable to environmental factors. Oxidative stress levels, metabolic pathways, including insulin, leptin, steroids, and arachidonic acid, DNA methylation, and histone configuration may be significantly altered by adverse environmental conditions. Studies on re-programming interventions focused on dietary or anti-oxidative approaches so far. Further studies that broaden our understanding of renal programming mechanisms are needed to ultimately develop preventive strategies. Targeted re-programming interventions in animal models focusing on known mechanisms will contribute to new concepts which finally will have to be translated

The predictive value of arterial stiffness on major adverse cardiovascular events in individuals with mildly impaired renal function

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Han J

2016-08-01

Full Text Available Jie Han,* Xiaona Wang,* Ping Ye, Ruihua Cao, Xu Yang, Wenkai Xiao, Yun Zhang, Yongyi Bai, Hongmei Wu Department of Geriatric Cardiology, Chinese PLA General Hospital, Beijing, People’s Republic of China *These authors contributed equally to this work Objectives: Despite growing evidence that arterial stiffness has important predictive value for cardiovascular disease in patients with advanced stages of chronic kidney disease, the predictive significance of arterial stiffness in individuals with mildly impaired renal function has not been established. The aim of this study was to evaluate the predictive value of arterial stiffness on cardiovascular disease in this specific population. Materials and methods: We analyzed measurements of arterial stiffness (carotid–femoral pulse-wave velocity [cf-PWV] and the incidence of major adverse cardiovascular events (MACEs in 1,499 subjects from a 4.8-year longitudinal study. Results: A multivariate Cox proportional-hazard regression analysis showed that in individuals with normal renal function (estimated glomerular filtration rate [eGFR] ≥90 mL/min/1.73 m2, the baseline cf-PWV was not associated with occurrence of MACEs (hazard ratio 1.398, 95% confidence interval 0.748–2.613; P=0.293. In individuals with mildly impaired renal function (eGFR <90 mL/min/1.73 m2, a higher baseline cf-PWV level was associated with a higher risk of MACEs (hazard ratio 2.334, 95% confidence interval 1.082–5.036; P=0.031. Conclusion: Arterial stiffness is a moderate and independent predictive factor for MACEs in individuals with mildly impaired renal function (eGFR <90 mL/min/1.73 m2. Keywords: epidemiology, arterial stiffness, impaired renal function, predictive value, MACEs

The effects of heart failure on renal function.

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Udani, Suneel M; Koyner, Jay L

2010-08-01

Heart-kidney interactions have been increasingly recognized by clinicians and researchers who study and treat heart failure and kidney disease. A classification system has been developed to categorize the different manifestations of cardiac and renal dysfunction. Work has highlighted the significant negative prognostic effect of worsening renal function on outcomes for individuals with heart failure. The etiology of concomitant cardiac and renal dysfunction remains unclear; however, evidence supports alternatives to the established theory of underfilling, including effects of venous congestion and changes in intra-abdominal pressure. Conventional therapy focuses on blockade of the renin-angiotensin-aldosterone system with expanding use of direct renin and aldosterone antagonists. Novel therapeutic interventions using extracorporeal therapy and antagonists of the adenosine pathway show promise and require further investigation. 2010 Elsevier Inc. All rights reserved.

Impaired renal function and increased urinary isoprostane excretion in Ghanaian women with pre-eclampsia

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Tetteh PW

2013-06-01

Full Text Available Paul Winston Tetteh,1,4 Charles Antwi-Boasiako,1 Ben Gyan,3 Daniel Antwi,1 Festus Adzaku,1 Kwame Adu-Bonsaffoh,1,2 Samuel Obed21Department of Physiology, 2Department of Obstetrics and Gynecology, University of Ghana Medical School, Accra, Ghana; 3Department of Immunology, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana; 4Hubrecht Institute for Developmental Biology and Stem Cell Research, Uppsalalaan 8, Utrecht, The NetherlandsBackground: The cause of pre-eclampsia remains largely unknown, but oxidative stress (an imbalance favoring oxidant over antioxidant forces has been implicated in contributing to the clinical symptoms of hypertension and proteinuria. Assessment of oxidative stress in pre-eclampsia using urinary isoprostane has produced conflicting results, and it is likely that renal function may affect isoprostane excretion. The aim of this study was to determine the role of oxidative stress in the pathophysiology of pre-eclampsia and to assess the effect of renal function on isoprostane excretion in pre-eclampsia in the Ghanaian population.Methods: This was a case-controlled study, comprising 103 pre-eclamptic women and 107 normal pregnant controls and conducted at the Korle-Bu Teaching Hospital between December 2006 and May 2007. The study participants were enrolled in the study after meeting the inclusion criteria and signing their written informed consent. Oxidative stress was determined by measuring urinary excretion of isoprostane and total antioxidant capacity using an enzyme-linked immunosorbent assay technique. Renal function was assessed by calculating the estimated glomerular filtration rate using the Modification of Diet in Renal Disease formula.Results: The pre-eclampsia group had significantly (P = 0.0006 higher urinary isoprostane excretion (2.81 ± 0.14 ng/mg creatinine than the control group (2.01 ± 0.18 ng/mg creatinine and a significantly (P = 0.0008 lower total antioxidant power (1

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

-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...... 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......, and renal oxidative stress. Alagebrium treatment, however, resulted in decreased weight gain and improved glycemic control compared with wild-type mice on a high-fat Western diet. Thus, targeted reduction of the advanced glycation pathway improved renal function in obesity....

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

International Nuclear Information System (INIS)

Han, Young min; Lee, Young Hwan; Kim, Sang Won; Jin, Kong Young; Kim, Won; Chung, Gyung Ho

2002-01-01

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

Evaluation of Renal Function in Pediatric Patients After Treatment for Wilms' Tumor.

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Janeczko, Małgorzata; Niedzielska, Ewa; Pietras, Wojciech

2015-01-01

Wilms' tumor is the most common kidney cancer in children. Treatment consists of pre- and post-operative chemotherapy, surgery and in some cases radiotherapy. The treatment of nephroblastomas is very effective. Hence, the population of adult patients cured of this cancer in their childhood is steadily growing, generating a need for long-term health assessment, including renal function, due to the specifications of the therapy and the location of the tumor. The aim of the study was to evaluate nephrological complications after treatment for nephroblastoma. The study group consisted of 50 children treated in the Department of Pediatric Hematology, Oncology and Bone Marrow Transplantation at Wroclaw Medical University (Poland) from 2002 to 2012. An analysis of the patients' medical histories was carried out. The glomerular filtration rate estimated by the Schwartz formula (GFR by Schwartz), serum creatinine levels, urea and electrolyte concentrations; the results of urinalysis and blood pressure were assessed. Each of these analyses was performed at the time of diagnosis, at the end of therapy, as well as 6 months, one year and two years after its completion. The study showed that, in most cases, implemented therapy had no significant impact on the deterioration of renal parameters in the two-year period following treatment for Wilms' tumor. However, the group of patients treated with cyclophosphamide and carboplatin required more careful monitoring, due to a higher risk of renal function deterioration. The study shows that the problem of nephrotoxicity after treatment for Wilms' tumor is more frequent than indicated in other studies; however, the deterioration of kidney function in most cases is not serious. Additional attention should be paid to patients treated with cyclophosphamide and carboplatin. Assessment of the early and late effects of the treatment is a key element in improving the quality of the patients' life.

Association of Renal Function and Menopausal Status with Bone Mineral Density in Middle-aged Women.

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Sheng, Yueh-Hsuan; Chen, Jen-Hau; Chiou, Jeng-Min; Tsai, Keh-Sung; Lee, Yue-Yuan; Tsao, Chwen-Keng; Chen, Yen-Ching

2015-10-13

The association between mild renal dysfunction and bone mineral density (BMD) has not been fully explored. It is also unclear how menopausal status and the use of Chinese herb affect this association. This is a cross-sectional study that included a total of 1,419 women aged 40 to 55 years old who were recruited from the MJ Health Management Institution in Taiwan between 2009 and 2010. Spinal BMD was assessed by dual-energy X-ray absorptiometry. Renal function was assessed using estimated glomerular filtration rate (eGFR) and creatinine clearance rate (CCr). The multivariable logistic regression and general linear models were employed to assess the association between renal function and BMD. Stratification analyses were performed by menopausal status and use of Chinese herbs. Low CCr levels were significantly associated with low BMD [adjusted odds ratio (AOR) = 1.48, 95% confidence interval (CI) = 1.15-1.90]. This association was observed in premenopausal women (AOR = 1.43, 95% CI = 1.07-1.92) and in women not taking Chinese herbs (AOR = 1.48, 95% CI = 1.14-1.94). CCr is a better predictor for low BMD in middle-aged women. Menopausal status and the use of Chinese herbs also affected this association.

Use of nonsteroidal anti-inflammatory drugs and renal failure in nursing home residents-results of the study "Inappropriate Medication in Patients with Renal Insufficiency in Nursing Homes".

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Dörks, Michael; Herget-Rosenthal, Stefan; Schmiemann, Guido; Hoffmann, Falk

2016-04-01

Use of potentially inappropriate medications may result in increased morbidity, mortality and resource utilisation. Due to polypharmacy and age-related decline in renal function the elderly population is at particular risk. Therefore, the Beers Criteria include use of nonsteroidal anti-inflammatory drugs in chronic renal failure stage 4 and 5 as these drugs may worsen renal function. According to the summary of product characteristics, the nonsteroidal anti-inflammatory drugs ibuprofen and diclofenac are contraindicated in these patients. Objective was to assess the extent of nonsteroidal anti-inflammatory drug use in nursing homes with a focus on residents with severe renal failure. Multi-centre cross-sectional study in 21 German nursing homes. The study population comprised residents for whom at least one serum creatinine value and information about sex were available, so that creatinine clearance rate could be estimated. In all, 685 of 852 residents were included as they fulfilled the abovementioned criteria. Renal failure was severe (estimated creatinine clearance rate renal failure (20.8 %). With one exception, all residents prescribed nonsteroidal anti-inflammatory drugs with severe renal failure were treated with at least one nonsteroidal anti-inflammatory drug that was contraindicated due to the underlying renal function. Notwithstanding their classification as potentially inappropriate medications and underlying contraindications, use of nonsteroidal anti-inflammatory drugs is common among nursing home residents with severe renal failure.

Bariatric surgery is associated with renal function improvement.

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Holcomb, Carla N; Goss, Lauren E; Almehmi, Ammar; Grams, Jayleen M; Corey, Britney L

2018-01-01

Weight loss after bariatric surgery improves both blood pressure and glycemic control following surgery. The effect of bariatric surgery on renal function is not well characterized. In this study, we sought to quantify the change in renal function over time following surgery. We retrospectively reviewed all patients who underwent laparoscopic Roux-en-Y gastric bypass (LRYGB) or laparoscopic sleeve gastrectomy (LSG) between 2012 and 2014 at our institution. The glomerular filtration rate (GFR, mL/min) was calculated using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation. Body mass index (BMI, kg/m 2 ) and percent weight loss (%WL) were calculated following the surgery. A total of 149 patients who underwent bariatric surgery were included in this study: LRYGB (n = 86 and LSG (n = 63). In LRYGB group, baseline BMI (kg/m 2 , ±SD) and GFR (mL/min, ±SD) were 48.5 ± 6.8 and 94.7 ± 23.8, respectively. In comparison, BMI and GFR were 49.1 ± 11.9 kg/m 2 and 93.1 ± 28.0 mL/min in the LSG group, respectively. Over the follow-up period (19.89 ± 10.93 months), the patients who underwent LRGYB lost a larger percentage of weight as compared to those in the LSG group (29.9 ± 11.7% vs 22.3 ± 10.7%; p = weight loss surgery (n = 62), 42% had improvement of their GFR to > 90 mL/min postoperatively (p weight loss percentage and GFR improvement (p = 0.8703). Bariatric surgery was associated with improvement in postoperative renal function at almost two years following surgery but was not different for LRYGB versus LSG. The gain in GFR was independent of percentage of weight lost suggesting an alternate mechanism in the improvement of renal function other than weight loss alone.

Renal aging in WKY rats: changes in Na+,K+ -ATPase function and oxidative stress.

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Silva, E; Pinto, V; Simão, S; Serrão, M P; Afonso, J; Amaral, J; Pinho, M J; Gomes, P; Soares-da-Silva, P

2010-12-01

It has been suggested that alterations in Na(+),K(+)-ATPase mediate the development of several aging-related pathologies, such as hypertension and diabetes. Thus, we evaluated Na(+),K(+)-ATPase function and H(2)O(2) production in the renal cortex and medulla of Wistar Kyoto (WKY) rats at 13, 52 and 91 weeks of age. Creatinine clearance, proteinuria, urinary excretion of Na(+) and K(+) and fractional excretion of Na(+) were also determined. The results show that at 91 weeks old WKY rats had increased creatinine clearance and did not have proteinuria. Despite aging having had no effect on urinary Na(+) excretion, urinary K(+) excretion was increased and fractional Na(+) excretion was decreased with age. In renal proximal tubules and isolated renal cortical cells, 91 week old rats had decreased Na(+),K(+)-ATPase activity when compared to 13 and 52 week old rats. In renal medulla, 91 week old rats had increased Na(+),K(+)-ATPase activity, paralleled by an increase in protein expression of α(1)-subunit of Na(+),K(+)-ATPase. In addition, renal H(2)O(2) production increased with age and at 91 weeks of age renal medulla H(2)O(2) production was significantly higher than renal cortex production. The present work demonstrates that although at 91 weeks of age WKY rats were able to maintain Na(+) homeostasis, aging was accompanied by alterations in renal Na(+),K(+)-ATPase function. The observed increase in oxidative stress may account, in part, for the observed changes. Possibly, altered Na(+),K(+)-ATPase renal function may precede the development of age-related pathologies and loss of renal function. Copyright © 2010 Elsevier Inc. All rights reserved.

Functional dynamic MR imaging and pharmacokinetics of Gd-DTPA in patients with renal failure

International Nuclear Information System (INIS)

Krestin, G.P.; Neufang, K.F.R.; Friedmann, G.; Clauss, W.; Schuhmann-Giampieri, G.; Stoeckl, B.

1989-01-01

This paper reports excretion of Gd-DTPA analyzed in 20 patients with renal parenchymal disease and decreased creatinine clearance (20-80 mL/min) and compared with excretion in five patients with normal renal function. All 25 underwent a dynamic MR study that employed fast gradient-echo sequences with single images during breath holding. The time between appearance of the contrast agent in the renal cortex and signal intensity drop in the medulla was an indicator of glomerular filtration rate and correlated well with creatinine clearance values. Fractionate urine collection and serum analysis up to 120 hours showed a prolonged but complete (98%) elimination of Gd-DTPA. Renal functional parameters did not change after administration of Gd-DTPA, and no nephrotoxic effects were observed. Thus, MR imaging provides a good quantitative evaluation of the glomerular filtration rate; moreover, administration of Gd-DTPA in patients with renal failure does not impair excretory function and can therefore be safely applied in patients with reduced excretory function

Experimental studies of renal blood flow by digitized functional angiography

International Nuclear Information System (INIS)

Buersch, J.H.; Ochs, C.; Hahne, H.J.; Heintzen, P.H.

1985-01-01

New techniques of digital image processing have been experimentally tested for the assessment of renal blood flow. The underlying principle in functional angiography is the extraction of flow parameters. Basically, density-time variations of the contrast medium are analayzed from to each picture element of a 256x256 matrix. The real-time acquisition rate of images was 25/sec. For the calculation of angiographic flow a PDP 11/40 computer was used to interactively perform a time dependent segmentation of the renal arteries and the aorta. Subsequently, volume flow was calculated in relative units for the specific vascular segments under study. 15 control angiograms were made in 5 animals with cardiac output ranging between 0.8 to 2.2l/min. Unilateral renal blood flow was calculated as 24+-3.4% of pre-renal aortic flow without systematic side differences. Reproducibility from repeated flow measurements showed an SD of +-1.8% of the individual pre-renal aortic flow. Renal flow was also measured in 3 animals with an experimentally created 50% flow reduction of the left kidney. Angiographic flow in the left renal artery dropped to 12+-2% of pre-renal flow. The present experimental data suggest that digital angiography has sufficient diagnostic capabilities for the detection of abnormal renal blood flow. The technique may serve as a useful diagnostic adjunct to conventional angiography and has the potential of assisting in the evaluation of renal vascular hypertension. (orig.) [de

Cross-Sectional Evaluation of Kidney Function in Hospitalized Patients: Estimated GFR Versus Renal Scintigraphy

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Domenico Santoro

2014-12-01

Full Text Available Background/Aims: Accurate staging of chronic kidney disease (CKD is very important. We tried to identify difference in GFR evaluation between CKD-EPI and Gates method with renal scintigraphy and which variables are associated with these differences. Methods: We retrospectively reviewed the records of 341 patients who underwent dynamic renal scintigraphy in the last 5 years. Patients were categorized according to KDIGO staging I to V, using the eGFR calculated with the CKD-EPI equation. Secondarily, we stratified patients according to treatment with renin-angiotensin system (RAS inhibitors. Results: Gates method tends to underestimate GFR especially in CKD stage I (mean -22.2 ml/min and II (mean -12.5 ml/min. The division in quartiles of ages showed an underestimation of GFR only in the first quartile of age (Conclusion: The assessment of GFR by the Gates method must be carefully considered in the early stages of CKD, especially in younger patients. Moreover, the difference is more pronounced in patients treated with RAS inhibitors. Longitudinal studies will prove which method better predicts cardiovascular or renal events.

Dynamic {sup 18}F-fluoride small animal PET to noninvasively assess renal function in rats

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Schnoeckel, Uta; Stegger, Lars; Schaefers, Klaus P.; Hermann, Sven; Schober, Otmar; Schaefers, Michael [Klinik und Poliklinik fuer Nuklearmedizin, Muenster (Germany); Reuter, Stefan; Schlatter, Eberhard; Gabriels, Gert [Universitaetsklinikum Muenster, Medizinische Klinik und Poliklinik D, Experimentelle Nephrologie, Muenster (Germany)

2008-12-15

Renal function can be quantified by both laboratory and scintigraphic methods. In the case of small animal diagnostics, scintigraphic image-based methods are ideal since they can assess split renal function, work noninvasively, and can be repeated. The aim of this study is to validate a {sup 18}F-PET-based method to quantify renal function in rats. Fluoride clearance was calculated from a dynamic whole body listmode acquisition of 60 min length in a small animal PET scanner following an i.v. injection of 15 MBq {sup 18}F-fluoride. Volumes of interest (VOIs) were placed in the left ventricle and the bladder as well as traced around the kidney contours. The respective time-activity curves (TAC) were calculated. The renal {sup 18}F-clearance was calculated by the ratio of the total renal excreted activity (bladder VOI) and the integral of the blood TAC. PET-derived renal function was validated by intraindividual measurements of creatinine clearance (n=23), urea clearance (n=23), and tubular excretion rate (TER-MAG3). The split renal function was derived from the injection of the clinically available radionuclide {sup 99m}Tc-mercaptotriglycine by blood sampling and planar renography (n=8). In all animals studied, PET revealed high-quality TACs. PET-derived renal fluoride clearance was linearly correlated with intraindividual laboratory measures (PET vs. creatinine: r=0.78; PET vs. urea: r=0.73; PET vs. TER-MAG3: r=0.73). Split function was comparable ({sup 18}F-PET vs. MAG3-renography: r=0.98). PET-derived measures were highly reproducible. {sup 18}F-PET is able to noninvasively assess renal function in rats and provides a significant potential for serial studies in different experimental scenarios. (orig.)

Dietary Energy Density, Renal Function, and Progression of Chronic Kidney Disease

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Mohammad Hossein Rouhani

2016-01-01

Full Text Available Background. There is evidence of the association between dietary energy density and chronic diseases. However, no report exists regarding the relation between DED and chronic kidney disease (CKD. Objective. To examine the association between dietary energy density (DED, renal function, and progression of chronic kidney disease (CKD. Design. Cross-sectional. Setting. Three nephrology clinics. Subjects. Two hundred twenty-one subjects with diagnosed CKD. Main Outcome Measure. Dietary intake of patients was assessed by a validated food frequency questionnaire. DED (in kcal/g was calculated with the use of energy content and weight of solid foods and energy yielding beverages. Renal function was measured by blood urea nitrogen (BUN, serum creatinine (Cr, and estimated glomerular filtration rate (eGFR. Results. Patients in the first tertile of DED consumed more amounts of carbohydrate, dietary fiber, potassium, phosphorus, zinc, magnesium, calcium, folate, vitamin C, and vitamin B2. After adjusting for confounders, we could not find any significant trend for BUN and Cr across tertiles of DED. In multivariate model, an increased risk of being in the higher stage of CKD was found among those in the last tertile of DED (OR: 3.15; 95% CI: 1.30, 7.63; P=0.01. Conclusion. We observed that lower DED was associated with better nutrient intake and lower risk of CKD progression.

Robustness of estimation of differential renal function in infants and children with unilateral prenatal diagnosis of a hydronephrotic kidney on dynamic renography: How real is the supranormal kidney?

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Ozcan, Zehra [University Faculty of Medicine, Nuclear Medicine Department of Ege, Bornova, Izmir (Turkey); Anderson, Peter J.; Gordon, Isky [Great Ormond Street Hospital For Children, Department of Radiology, London (United Kingdom)

2006-06-15

The two methods recommended for estimation of differential renal function (DRF) in the renography guidelines published by the European Association of Nuclear Medicine are the area under the background-subtracted time-activity curves (AUCs) (often called the integral method) and the regression slope of the background-subtracted Rutland/Patlak plot analysis. The current study investigated the agreement/disagreement of DRF estimations obtained using these two techniques. This report also focusses on the occurrence of supranormal function of the affected kidney (defined as DRF >55%) and reviews the related technical and physiological factors. A total of 394 renographic studies in 101 children with a prenatal diagnosis of unilateral renal pelvic dilatation confirmed on postnatal studies were retrieved from optical disc and reprocessed by one author. DRF was calculated using the Rutland/Patlak plot and the AUC over the time period 40-120 s following an injection of{sup 99m}Tc-mercaptoacetyltriglycine. The difference in DRF between the methods (Rutland/Patlak minus AUC) and 95% limits of agreement were calculated. The age distribution of the difference between the methods was also analysed. For all 394 measurements the mean difference was -0.8% (range -21.0% to 16.9%, SD 3.9%). The 95% limits of agreement were -7.0% to 8.6%. Analysis of the data revealed that greater spread of DRF between the techniques was seen in studies performed at a younger age: a discrepancy of >5% DRF was significantly more common in those <1 year of age than in those >1 year old (25.3% vs 9.9%; chi-square, p<0.0005). Supranormal function was found less frequently using the Rutland/Patlak method than with the AUC method (8.4% vs 11.2%; chi-square, p<0.0005). The frequency of this diagnosis was reduced to 4.6% when both methods were required to be in agreement. (orig.)

Smoking and renal function in people living with human immunodeficiency virus: a Danish nationwide cohort study

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Ahlström MG

2015-08-01

Full Text Available Magnus Glindvad Ahlström,1 Bo Feldt-Rasmussen,2 Rebecca Legarth,1 Gitte Kronborg,3 Court Pedersen,4 Carsten Schade Larsen,5 Jan Gerstoft,1 Niels Obel1 1Department of Infectious Diseases, 2Department of Nephrology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, 3Department of Infectious Diseases, Copenhagen University Hospital, Hvidovre, 4Department of Infectious Diseases, Odense University Hospital, Odense, 5Department of Infectious Diseases, Aarhus University Hospital, Skejby, Aarhus, Denmark Introduction: Smoking is a main risk factor for morbidity and mortality in people living with human immunodeficiency virus (PLHIV, but its potential association with renal impairment remains to be established. Methods: We did a nationwide population-based cohort study in Danish PLHIV to evaluate the association between smoking status and 1 overall renal function and risk of chronic kidney disease (CKD, 2 risk of any renal replacement therapy (aRRT, and 3 mortality following aRRT. We calculated estimated creatinine clearance using the Cockcroft–Gault equation (CG-CrCl, and evaluated renal function graphically. We calculated cumulative incidence of CKD (defined as two consecutive CG-CrCls of ≤60 mL/min, ≥3 months apart and aRRT and used Cox regression models to calculate incidence rate ratios (IRRs for risk of CKD, aRRT, and mortality rate ratios (MRRs following aRRT. Results: From the Danish HIV Cohort Study, we identified 1,475 never smokers, 768 previous smokers, and 2,272 current smokers. During study period, we observed no association of smoking status with overall renal function. Previous and current smoking was not associated with increased risk of CKD (adjusted IRR: 1.1, 95% confidence interval [CI]: 0.7–1.7; adjusted IRR: 1.3, 95% CI: 0.9–1.8 or aRRT (adjusted IRR: 0.8, 95% CI: 0.4–1.7; adjusted IRR: 0.9, 95% CI: 0.5–1.7. Mortality following aRRT was high in PLHIV and increased in smokers vs never smokers (adjusted MRR: 3

Renal function after unilateral nephrectomy for Wilms' tumour: the influence of radiation therapy

International Nuclear Information System (INIS)

Graaf, S.S.N. de; Gent, H. van; Reitsma-Bierens, W.Ch.C.; Luyk, W.H.J. van; Postma, A.; Dolsma, W.V.

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 125 I-iothalamate clearance and 131 I-hippurate clearance. Of 41 evaluable patients, 29 received chemotherapy as sole treatment modality following nephrectomy (group 1); 12 patients additionally received radiation therapy to a field that included the remaining kidney (group 2). Results were expressed as standard deviation scores (z-scores). In group 1, mean z-score for GFR was -0.27 (94.6% of normal) and in group 2 mean z-score was -1.51 (72.7% of normal for two kidneys) (P = 0.022, Mann-Whitney U-test). Mean z-score for ERPF was -0.09 (97.0%) in group 1 and -1.53 (73.8%) in group 2 (P 0.039). It was concluded that the combination of chemotherapy and radiation therapy, in contrast to chemotherapy alone, negatively affects the ability of the remaining kidney to adjust its function after the loss of its counterpart. (author)

Diuretic renography in neonates and infants with congenital obstructive hydronephrosis for evaluating post-operative renal function

International Nuclear Information System (INIS)

Li Jianing; Yang Shurong; Fu Hongliang; Gu Zhenhui; Chen Fang; Xie Hua; Zou Renjian; Wu Jingchuan

2003-01-01

Objective: To study the value of diuretic renography (DR) in evaluation of renal function after operation in congenital obstructive hydronephrosis (HN) in neonates and infants. Methods: Thirty-two patients with the disease detected in their neonatal or infantile period were submitted to this study. DR was performed 1 to 4 times on all patients during follow-up. The qualitative evaluation of renal function after operation was combined with renal morphology, renogram curve and several other renal function indexes. The major index of quantitative evaluation of renal function is the change of renal blood perfusion rate (BPR). Results: The results of qualitative evaluation with 67 DR in the affected kidney (AK): 6 totally recovered, 35 significantly improved, 7 improved, 9 unchanged, 10 deteriorated. The changes of BPR of the groups with qualitative evaluation differed from each other significantly (F=7.77, P 0.05 and r=0.166, P>0.05, respectively). Conclusion: The change of BPR is a good index of renal function after operation, but only the quantitative evaluation being combined with qualitative evaluation can be considered a complete evaluation

Classification of tubulo-papillary renal cortical tumours using estimates of nuclear volume

DEFF Research Database (Denmark)

Brooks, B; Sørensen, Flemming Brandt; Olsen, S

1993-01-01

The classification of renal cortical tumours is problematic, with no clear division of benign from malignant tumours. Unbiased stereological estimates of volume-weighted nuclear volume (nuclear vv) were obtained by point sampling of nuclear intercepts in a retrospective study of 36 variably sized...

Hemodynamics, functional state of endothelium and renal function, platelets depending on the body mass index in patients with chronic heart failure and preserved systolic function

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Kushnir Yu.

2014-03-01

Full Text Available The aim of the study was to evaluate hemodynamics, endothelium function of kidneys and platelets depending on the body mass index (BMI in patients with chronic heart failure (CHF and preserved systolic function. 42 patients (mean age - 76,690,83 years with CHF II-III FC NYHA with preserved systolic function (LVEF>45% were enrolled. Echocardiography was performed, endothelial function, serum creatinine levels and microalbuminuria were determined in patients. BMI and glomerulation filtration rate were calculated by formulas. The morphological and functional status of platelets was estimated by electronic microscopy. It was defined that increased BMI in patients with CHF and preserved systolic function determines the structural and functional changes of the myocardium and leads to the endothelial and renal functional changes. An increased risk of thrombogenesis was established in patients with overweight and obesity.

Ibuprofen exposure in early neonatal life does not affect renal function in young adolescence.

Science.gov (United States)

Raaijmakers, Anke; Zhang, Zhen-Yu; Levtchenko, Elena; Simons, Sinno Hp; Cauwenberghs, Nicholas; Heuvel, Lambertus P van den; Jacobs, Lotte; Staessen, Jan A; Allegaert, Karel

2018-03-01

Ibuprofen exposure results in acute transient renal dysfunction in preterm neonates, but we are unaware of data on long-term renal safety. In a previously studied cohort of extreme low birth weight (ELBW, ibuprofen. In this post hoc analysis, we linked markers of renal function in young adolescence in ELBW cases with their perinatal (prenatal maternal, setting at birth, treatment modalities including drug prescription during neonatal stay, neonatal creatinine values, postdischarge growth) characteristics, including but not limited to ibuprofen exposure during neonatal stay. Ibuprofen exposure was not associated with significant differences in renal length or eGFR cysC . Moreover, we were unable to identify any other risk factor (perinatal characteristics, postnatal creatinine trends, postdischarge growth) on renal outcome in this cohort. Neonatal exposure to ibuprofen did not affect renal function. Larger studies are needed to explore the confounders of variability in renal function in former ELBW cases. This matters since ELBW relates to risk for hypertension, cardiovascular events and renal disease in later life and identification of risk factors holds the promise of secondary prevention. NCT02147457. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Focused ultrasound-modulated glomerular ultrafiltration assessed by functional changes in renal arteries.

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Feng-Yi Yang

Full Text Available This study demonstrates the feasibility of using focused ultrasound (FUS to modulate glomerular ultrafiltration by renal artery sonication and determine if protein-creatinine ratios are estimated through vascular parameters. All animal experiments were approved by our Animal Care and Use Committee. The renal arteries of Sprague-Dawley rats were surgically exposed and sonicated at various acoustic power levels using a FUS transducer with a resonant frequency of 1 MHz. The mean peak systolic velocity (PSV of the blood flow was measured by Doppler ultrasound imaging. Urinary protein-creatinine ratios were calculated during the experiments. Histological examination of renal arteries and whole kidneys was performed. The PSV, pulsatility index, and resistance index of blood flow significantly increased in the arteries after FUS sonication without microbubbles (p<0.05. The change in normalized protein-creatinine ratios significantly increased with increasing acoustic power, but such was not observed when microbubbles were administered. Furthermore, no histological changes were observed in the hematoxylin- and eosin-stained sections. Glomerular ultrafiltration is regulated temporarily by renal artery sonication without microbubbles. Monitoring vascular parameters are useful in estimating the normalized change in protein-creatinine ratios.

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

Renal blood flow (RBF) was measured in 9 patients with chronic impaired kidney function using MR velocity mapping and compared to PAH clearance and 99mTc-DTPA scintigraphy. An image plane suitable for flow measurement perpendicular to the renal arteries was chosen from 2-dimensional MR angiography....... 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 99mTc-DTPA scintigraphy. A reduction of RBF was found, and there was a significant correlation between PAH clearance multiplied by 1/(1-hematocrit) and RBF determined by MR velocity mapping. Furthermore, a significant correlation between the distribution of renal function and the percent distribution...

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

DEFF Research Database (Denmark)

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

2000-01-01

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

An experimental study on recovery of renal function using 99mTc DMSA scintigram after percutaneous nephrostomy in unilateral hydronephrosis

International Nuclear Information System (INIS)

Moon, Tae Yong; Nam, Sang Hwa; Park, Jong Yeon; Kim, Byung Soo

1992-01-01

Obstruction on the urinary tract eventually results in damage to the kidneys and lose of function. The questions that concern the clinician are the degree of nephron loss in that kidney and potential for recovery following the relief of obstruction. 99m Tc DMSA accumulates in tubule cells and has been proposed as a marker of the tubular mass. The authors estimated the renal uptake ratio of 99m Tc DMSA for the degree of nephron loss corresponding to duration of hydronephrosis following left ureteral ligation in 5 New Zealand white rabbits and the potential for recovery following percutaneous nephrostomy of hydronephrosis in 24 rabbits. While the renal uptake ratio of 99m Tc DMSA of the kidney with unilateral hydronephrosis following ureteral ligation reduced dramatically within 24 hour, that of the opposite healthy kidney increased, and the total renal uptake ratio was same as normal functioning kidneys before ureteral ligation. Upon ureteral release, there was no evidence of definite recovery or impairment in the experimental kidneys for 5 days. The authors conclude that a combination of ureteral release and administration of some drugs such as renal vasodilator or diuretics is an appropriate treatment for the recovery of function in unilateral hydronephrosis

Assessment of renal function in routine care of people living with HIV on ART in a resource-limited setting in urban Zambia.

Science.gov (United States)

Deckert, Andreas; Neuhann, Florian; Klose, Christina; Bruckner, Thomas; Beiersmann, Claudia; Haloka, John; Nsofwa, Mannie; Banda, Greg; Brune, Maik; Reutter, Helmut; Rothenbacher, Dietrich; Zeier, Martin

2017-01-01

Data on renal impairment in sub-Saharan Africa (SSA) remains scarce, determination of renal function is not part of routine assessments. We evaluated renal function and blood pressure in a cohort of people living with HIV (PLWH) on antiretroviral treatment (ART) in the Renal Care Zambia project (ReCaZa). Using routine data from an HIV outpatient clinic from 2011-2013, we retrospectively estimated the glomerular filtration rate (eGFR, CKD-Epi formula) of PLWH on ART in Lusaka, Zambia. Data were included if adults had had at least one serum creatinine recorded and had been on ART for a minimum of three months. We investigated the differences in eGFR between ART subgroups with and without tenofovir disproxil fumarate (TDF), and applied multivariable linear models to associate ART and eGFR, adjusted for eGFR before ART initiation. Among 1118 PLWH (63,3% female, mean age 41.8 years, 83% ever on TDF; median duration 1461 [range 98 to 4342] days) on ART, 28.3% had an eGFR ART had an initial eGFR lower 60ml/min. Nineteen percent had first-time hypertensive readings at their last visit. The multivariable models suggest that physicians acted according to guidelines and replaced TDF-containing ART if patients developed moderate/severe renal impairment. Assessment of renal function in SSA remains a challenge. The vast majority of PLWH benefit from long-term ART, including improved renal function. However, approximately 5% of PLWH on ART may have clinically relevant decreased eGFR, and 27% hypertension. While a routine renal assessment might not be feasible, strategies to identify patients at risk are warranted. Targeted monitoring prior and during ART is recommended, however, should not delay ART access.

Renal filtration function in patients with gout

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N. N. Kushnarenko

2016-01-01

Full Text Available Aim. To study circadian blood pressure (BP profile in patients with gout depending on the presence of arterial hypertension (HT and their relationship to the renal filtration function.Material and methods. Patients with gout (n=87 were included into the study. All the patients underwent ambulatory BP monitoring (ABPM with the assessment of circadian BP profile, determination of uric acid serum levels, glomerular filtration rate (GFR was evaluated by CKD-EPI method. Depending on GFR level, all the patients were divided into 2 groups - with renal dysfunction or without one.Results. ABPM revealed circadian BP dysregulation in 55% of gout patients both with HT and without HT. Chronic kidney disease (CKD was revealed in 72.4% of male patients, with the prevalence in patients with HT (76.6 vs 61%; p<0.001. Correlations between uric acid levels and some ABPM indicators and GFR were determined.Conclusion. Obtained data suggest the contribution of hyperuricemia in disorders of systemic and renal hemodynamics, leading to the early development of CKD.

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

International Nuclear Information System (INIS)

Moser, E.A.

1980-01-01

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

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

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Chih-Yuan Chou

2015-06-01

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

Early release of neonatal ureteral obstruction preserves renal function

DEFF Research Database (Denmark)

Shi, Yimin; Pedersen, Michael; Li, Chunling

2004-01-01

was left in place or released after 1 or 4 wk. Renal blood flow (RBF) and kidney size were measured sequentially over 24 wk using MRI. In rats in which the obstruction was left in place, RBF of the obstructed kidney was progressively reduced to 0.92 ± 0.17 vs. 1.79 ± 0.12 ml·min−1·100 g body wt−1 (P ...The incidence of congenital hydronephrosis is ∼1% and is often associated with renal insufficiency. It is unknown whether early release is essential to prevent deterioration of renal function. Rats were subjected to partial unilateral ureteral obstruction (PUUO) on postnatal day 2. The obstruction...... downregulation of Na-K-ATPase to 62 ± 7%, aquaporin-1 to 53 ± 3%, and aquaporin-3 to 53 ± 7% of sham levels. Release after 1 wk completely prevented development of hydronephrosis, reduction in RBF and glomerular filtration rate, and downregulation of renal transport proteins, whereas release after 4 wk had...

Echo and BNP serial assessment in ambulatory heart failure care: Data on loop diuretic use and renal function.

Science.gov (United States)

Dini, Frank Lloyd; Simioniuc, Anca; Carluccio, Erberto; Ghio, Stefano; Rossi, Andrea; Biagioli, Paolo; Reboldi, Gianpaolo; Galeotti, Gian Giacomo; Lu, Fei; Zara, Cornelia; Whalley, Gillian; Temporelli, Pier Luigi

2016-12-01

We compared the follow-up data on loop diuretic use and renal function, as assessed by serum creatinine levels, and the estimated glomerular filtration rate (eGFR), of two groups of consecutive ambulatory HF patients: 1) the clinically-guided group, in which management was clinically driven based on the institutional protocol of the HF Unit of the Cardiovascular and Thoracic Department of Pisa (standard of care) and 2) the echo and B-type natriuretic peptide (BNP) guided group (patients conforming to the protocol of the Network Labs Ultrasound (NEBULA) in HF Study Group: Pisa, Perugia, Pavia; Verona, Auckland, and Veruno), in which therapy was delivered according to the serial assessment of BNP and echocardiography. Patients whose follow-up was based on standard of care had a significant higher prevalence of worsening renal function, that was likely related to higher diuretic dosages, whilst, a better management of renal function was observed in the echo-BNP-guided group. The data is related to "Echo and natriuretic peptide guided therapy improves outcome and reduces worsening renal function in systolic heart failure: An observational study of 1137 outpatients" (A. Simioniuc, E. Carluccio, S. Ghio, A. Rossi, P. Biagioli, G. Reboldi, G.G. Galeotti, F. Lu, C. Zara, G. Whalley, P.G. Temporelli, F.L. Dini, 2016; K.J. Harjai, H.K. Dinshaw, E. Nunez, M. Shah, H. Thompson, T. Turgut, H.O. Ventura, 1999; A. Ahmed, A. Husain, T.E. Love, G. Gambassi, L.J. Dell׳Italia, G.S. Francis, M. Gheorghiade, R.M. Allman, S. Meleth, R.C. Bourge, 2006) [1], [2], [3].

AGXT2 rs37369 polymorphism predicts the renal function in patients with chronic heart failure.

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Hu, Xiao-Lei; Zeng, Wen-Jing; Li, Mu-Peng; Yang, Yong-Long; Kuang, Da-Bin; Li, He; Zhang, Yan-Jiao; Jiang, Chun; Peng, Li-Ming; Qi, Hong; Zhang, Ke; Chen, Xiao-Ping

2017-12-30

Patients with chronic heart failure (CHF) are often accompanied with varying degrees of renal diseases. The purpose of this study was to identify rs37369 polymorphism of AGXT2 specific to the renal function of CHF patients. A total of 1012 southern Chinese participants, including 487 CHF patients without history of renal diseases and 525 healthy volunteers, were recruited for this study. Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) was used to determine the genotypes of AGXT2 rs37369 polymorphism. Levels of blood urea nitrogen (BUN) and serum creatinine (SCr) were detected to indicate the renal function of the participants. BUN level was significantly higher in CHF patients without history of renal diseases compared with healthy volunteers (p=0.000). And the similar result was also obtained for SCr (p=0.000). Besides, our results indicated that the level of BUN correlated significantly with SCr in both the CHF patients without renal diseases (r=0.4533, prenal diseases (p=0.036, AA+AG vs GG). Patients with rs37369 GG genotype showed a significantly reduced level of BUN compared to those with the AA genotype (p=0.024), and the significant difference was still observed in the smokers of CHF patients without renal diseases (p=0.023). In conclusion, we found that CHF might induce the impairment of kidney and cause deterioration of renal function. AGXT2 rs37369 polymorphism might affect the renal function of CHF patients free from renal diseases, especially in patients with cigarette smoking. Copyright © 2017. Published by Elsevier B.V.

Serum uromodulin—a marker of kidney function and renal parenchymal integrity

Science.gov (United States)

Scherberich, Jürgen E; Gruber, Rudolf; Nockher, Wolfgang Andreas; Christensen, Erik Ilsø; Schmitt, Hans; Herbst, Victor; Block, Matthias; Kaden, Jürgen; Schlumberger, Wolfgang

2018-01-01

Abstract Background An ELISA to analyse uromodulin in human serum (sUmod) was developed, validated and tested for clinical applications. Methods We assessed sUmod, a very stable antigen, in controls, patients with chronic kidney disease (CKD) stages 1–5, persons with autoimmune kidney diseases and recipients of a renal allograft by ELISA. Results Median sUmod in 190 blood donors was 207 ng/mL (women: men, median 230 versus 188 ng/mL, P = 0.006). sUmod levels in 443 children were 193 ng/mL (median). sUmod was correlated with cystatin C (rs = −0.862), creatinine (rs = −0.802), blood urea nitrogen (BUN) (rs = −0.645) and estimated glomerular filtration rate (eGFR)–cystatin C (rs  =  0.862). sUmod was lower in systemic lupus erythematosus-nephritis (median 101 ng/mL), phospholipase-A2 receptor- positive glomerulonephritis (median 83 ng/mL) and anti-glomerular basement membrane positive pulmorenal syndromes (median 37 ng/mL). Declining sUmod concentrations paralleled the loss of kidney function in 165 patients with CKD stages 1–5 with prominent changes in sUmod within the ‘creatinine blind range’ (71–106 µmol/L). Receiver-operating characteristic analysis between non-CKD and CKD-1 was superior for sUmod (AUC 0.90) compared with eGFR (AUC 0.39), cystatin C (AUC 0.39) and creatinine (AUC 0.27). sUmod rapidly recovered from 0 to 62 ng/mL (median) after renal transplantation in cases with immediate graft function and remained low in delayed graft function (21 ng/mL, median; day 5–9: relative risk 1.5–2.9, odds ratio 1.5–6.4). Immunogold labelling disclosed that Umod is transferred within cytoplasmic vesicles to both the apical and basolateral plasma membrane. Umod revealed a disturbed intracellular location in kidney injury. Conclusions We conclude that sUmod is a novel sensitive kidney-specific biomarker linked to the structural integrity of the distal nephron and to renal function. PMID:28206617

Development of a definition for Rapid Progression (RP) of renal function in HIV-positive persons : the D:A:D study

NARCIS (Netherlands)

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

2014-01-01

BACKGROUND: No consensus exists on how to define abnormally rapid deterioration in renal function (Rapid Progression, RP). We developed an operational definition of RP in HIV-positive persons with baseline estimated glomerular filtration rate (eGFR) >90 ml/min/1.73 m2 (using Cockcroft Gault) in the

Development of a definition for Rapid Progression (RP) of renal function in HIV-positive persons: the D:A:D study

NARCIS (Netherlands)

Kamara, David A.; Ryom, Lene; Ross, Michael; Kirk, Ole; Reiss, Peter; Morlat, Philippe; Moranne, Olivier; Fux, Christoph A.; Mocroft, Amanda; Sabin, Caroline; Lundgren, Jens D.; Smith, Colette J.; Powderly, B.; Shortman, N.; Moecklinghoff, C.; Reilly, G.; Franquet, X.; Ryom, L.; Sabin, C. A.; Kamara, D.; Smith, C.; Phillips, A.; Mocroft, A.; Tverland, J.; Mansfeld, M.; Nielsen, J.; Raben, D.; Lundgren, J. D.; Brandt, R. Salbøl; Rickenbach, M.; Fanti, I.; Krum, E.; Hillebregt, M.; Geffard, S.; Sundström, A.; Prins, J. M.; Kuijpers, T. W.; Scherpbier, H. J.; van der Meer, J. T. M.; Wit, F. W. M. N.; Godfried, M. H.; Nellen, F. J. B.; Lange, J. M. A.; Geerlings, S. E.; van Vugt, M.; Pajkrt, D.; Grijsen, M. L.; Wiersinga, W. J.; Goorhuis, A.; Hovius, J. W. R.

2014-01-01

No consensus exists on how to define abnormally rapid deterioration in renal function (Rapid Progression, RP). We developed an operational definition of RP in HIV-positive persons with baseline estimated glomerular filtration rate (eGFR) >90 ml/min/1.73 m2 (using Cockcroft Gault) in the Data

Development of a definition for Rapid Progression (RP) of renal function in HIV-positive persons: the D:A:D study

NARCIS (Netherlands)

Kamara, D.A.; Ryom, L.; Ross, M.; Kirk, O.; Reiss, P.; Morlat, P.; Moranne, O.; Fux, C.A.; Mocroft, A.; Sabin, C.; Lundgren, J.D.; Smith, C.J.; Koopmans †, P.P.; Keuter, M.; Ven, A.J.A.M. van der; Hofstede, H.J.M. ter; Dofferhoff, A.S.M.; Warris, A.; Crevel, R. van; et al.,

2014-01-01

BACKGROUND: No consensus exists on how to define abnormally rapid deterioration in renal function (Rapid Progression, RP). We developed an operational definition of RP in HIV-positive persons with baseline estimated glomerular filtration rate (eGFR) >90 ml/min/1.73 m2 (using Cockcroft Gault) in the

Renal function trajectory is more important than chronic kidney disease stage for managing patients with chronic kidney disease.

Science.gov (United States)

Rosansky, Steven J

2012-01-01

Management of patients with chronic kidney disease (CKD) emphasizes a current level of function as calculated from the modification of diet in renal disease glomerulofiltration rate equations (eGFR) and proteinuria for staging of CKD. Change in a patient's eGFR over time (renal function trajectory) is an additional and potentially more important consideration in deciding which patients will progress to the point where they will require renal replacement therapy (RRT). Many patients with CKD 3-5 have stable renal function for years. Proteinuria/albuminuria is a primary determinant of renal trajectory which may be slowed by medications that decrease proteinuria and/or aggressively lower blood pressure. A renal trajectory of >3 ml/min/1.73 m(2)/year may relate to a need for closer renal follow-up and increased morbidity and mortality. Additional CKD population-based studies need to examine the relationship of renal trajectory to: baseline renal function; acute kidney injury episodes; age, race, sex and primary etiologies of renal disease; blood pressure control and therapies; dietary protein intake; blood glucose control in diabetics and the competitive risk of death versus the requirement for renal replacement therapy. In the elderly CKD 4 population with significant comorbidities and slow decline in renal function, the likelihood of death prior to the need for RRT should be considered before placing AV access for dialysis. Prediction models of renal progression must account for the competitive risk of death as well as stable or improved renal function to be clinically useful. Copyright © 2012 S. Karger AG, Basel.

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

International Nuclear Information System (INIS)

Graceli, J.B.; Cicilini, M.A.; Bissoli, N.S.; Abreu, G.R.; Moysés, M.R.

2013-01-01

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

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

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Chavhan, Govind; Daneman, Alan; Lim, Ruth; Traubici, Jeffrey [University of Toronto, Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto (Canada); Moineddin, Rahim [University of Toronto, Department of Family and Community Medicine, Toronto (Canada); Langlois, Valerie [University of Toronto, Division of Nephrology, Department of Pediatrics, Hospital for Sick Children, Toronto (Canada)

2008-10-15

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

Inflammation and renal function after a four-year follow-up in subjects with unimpaired glomerular filtration rate: results from the observational, population-based CARLA cohort.

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Daniel Medenwald

Full Text Available There is evidence that chronic inflammation is associated with the progression/development of chronic renal failure; however, relations in subjects with preserved renal function remain insufficiently understood.To examine the association of inflammation with the development of renal failure in a cohort of the elderly general population.After excluding subjects with reduced estimated glomerular filtration rate (eGFR<60 mL/min/1.73 m2 and missing data, the cohort incorporated 785 men and 659 women (aged 45-83 years. Follow-up was performed four years after baseline. Covariate adjusted linear and logistic regression models were used to assess the association of plasma/serum concentrations of soluble tumour necrosis factor receptor 1 (sTNF-R1, C-reactive protein (CRP, and interleukin 6 (IL-6 with change in eGFR/creatinine. The areas under the curve (AUCs from receiver operating characteristics (ROCs were estimated.In adjusted models sTNF-R1 was distinctively associated with a decline in eGFR in men (0.6 mL/min/1.73 m2 per 100 pg/mL sTNF-R1; 95% CI: 0.4-0.8, but not in women. A similar association could not be found for CRP or IL-6. Estimates of sTNF-R1 in the cross-sectional analyses were similar between sexes, while CRP and IL-6 were not relevantly associated with eGFR/creatinine.In the elderly male general population with preserved renal function sTNF-R1 predicts the development of renal failure.

Features of Mineral Metabolism and Parathyroid Glands Functioning in Chronic Renal Disease

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L.P. Martynyuk

2012-04-01

Full Text Available The calcium phosphoric metabolism was analyzed depending on the severity of renal functioning disorders. Chronic renal disease is known to be associated with impaired mineral metabolism in terms of hypocalcaemia, hyperphosphatemia and enhanced level of Ca × P product that aggravates in chronic renal failure progression. The majority of patients with nephropathy have parathyroid hormone concentration to be different from target one recommended by NKF-K/DOQI (2003, at that secondary hyperparathyroidism prevails on pre-dialysis stage of chronic renal disease, the relative hypoparathyroidism is common among the patients received dialysis.

Renal Function and Ultrasound Imaging in Elderly Subjects

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Luca Zanoli

2014-01-01

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

Prediction of cardiovascular outcome by estimated glomerular filtration rate and estimated creatinine clearance in the high-risk hypertension population of the VALUE trial.

Science.gov (United States)

Ruilope, Luis M; Zanchetti, Alberto; Julius, Stevo; McInnes, Gordon T; Segura, Julian; Stolt, Pelle; Hua, Tsushung A; Weber, Michael A; Jamerson, Ken

2007-07-01

Reduced renal function is predictive of poor cardiovascular outcomes but the predictive value of different measures of renal function is uncertain. We compared the value of estimated creatinine clearance, using the Cockcroft-Gault formula, with that of estimated glomerular filtration rate (GFR), using the Modification of Diet in Renal Disease (MDRD) formula, as predictors of cardiovascular outcome in 15 245 high-risk hypertensive participants in the Valsartan Antihypertensive Long-term Use Evaluation (VALUE) trial. For the primary end-point, the three secondary end-points and for all-cause death, outcomes were compared for individuals with baseline estimated creatinine clearance and estimated GFR or = 60 ml/min using hazard ratios and 95% confidence intervals. Coronary heart disease, left ventricular hypertrophy, age, sex and treatment effects were included as covariates in the model. For each end-point considered, the risk in individuals with poor renal function at baseline was greater than in those with better renal function. Estimated creatinine clearance (Cockcroft-Gault) was significantly predictive only of all-cause death [hazard ratio = 1.223, 95% confidence interval (CI) = 1.076-1.390; P = 0.0021] whereas estimated GFR was predictive of all outcomes except stroke. Hazard ratios (95% CIs) for estimated GFR were: primary cardiac end-point, 1.497 (1.332-1.682), P cause death, 1.231 (1.098-1.380), P = 0.0004. These results indicate that estimated glomerular filtration rate calculated with the MDRD formula is more informative than estimated creatinine clearance (Cockcroft-Gault) in the prediction of cardiovascular outcomes.

Residual Renal Function in Children Treated with Chronic Peritoneal Dialysis

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Maria Roszkowska-Blaim

2013-01-01

Full Text Available Residual renal function (RRF in patients with end-stage renal disease (ESRD receiving renal replacement therapy is defined as the ability of native kidneys to eliminate water and uremic toxins. Preserved RRF improves survival and quality of life in adult ESRD patients treated with peritoneal dialysis. In children, RRF was shown not only to help preserve adequacy of renal replacement therapy but also to accelerate growth rate, improve nutrition and blood pressure control, reduce the risk of adverse myocardial changes, facilitate treatment of anemia and calcium-phosphorus balance abnormalities, and result in reduced serum and dialysate fluid levels of advanced glycation end-products. Factors contributing to RRF loss in children treated with peritoneal dialysis include the underlying renal disease such as hemolytic-uremic syndrome and hereditary nephropathy, small urine volume, severe proteinuria at the initiation of renal replacement therapy, and hypertension. Several approaches can be suggested to decrease the rate of RRF loss in pediatric patients treated with chronic peritoneal dialysis: potentially nephrotoxic drugs (e.g., aminoglycosides, episodes of hypotension, and uncontrolled hypertension should be avoided, urinary tract infections should be treated promptly, and loop diuretics may be used to increase salt and water excretion.

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

International Nuclear Information System (INIS)

Ulusoy, Şükrü; Özkan, Gülsüm; Dinç, Hasan; Kaynar, Kübra; Öztürk, Mehmet Halil; Gül, Semih; Kaplan, Safiye Tuba

2011-01-01

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

Effective renal blod flow and canalicular function of kidneys obliterating endarteritis

International Nuclear Information System (INIS)

Davydova, L.I.; Zajtsev, V.T.; Kononenko, E.I.; Gorbenko, L.V.; Karpovich, I.P.; Troyan, V.I.; Skripko, V.A.; Belousova, L.G.; Pavlova, T.S.

1978-01-01

Effective renal blood flow (general and separate) as well as the secretory-evacuatory function of the canalicular system of kidneys in 39 patients with obliterating endarteritis and in 20 persons of a control group have been studied by means of hippuran 131 I. Considerable decrease in the effective renal blood flow has been revealed. The decrease in blood flow with the increase in the ischemia degree turned out to be insignificant. The total function of kidneys is reduced in the 2-5 stages of diseases. Indices of secretory - evacuatory function of canals were changed. Indices of the total function of kidneys and intrarenal hemodynamics are the most informative when studying the state of this organ

The effect of pregnancy on renal function: physiology and pathophysiology.

Science.gov (United States)

Dafnis, E; Sabatini, S

1992-03-01

Marked changes in renal function occur with pregnancy. We present a summary of these changes in this review and give insight into possible mechanisms if they are known. Controversies exist regarding the therapy of pregnancy-induced hypertension and asymptomatic and recurrent bacteriuria. The current views on these topics are given. Specific renal diseases are summarized, including transplantation, and optimum management strategies and maternal and fetal prognosis during pregnancy are given.

Dynamic changes in biochemical markers of renal function with ...

African Journals Online (AJOL)

Thyroid dysfunction is known to cause significant changes in glomerular filtration rate. The present cross-sectional study was performed to evaluate the changes in biochemical markers of renal function in hypothyroid subjects before and after treatment. Thyroid function tests (T3, T4 and TSH levels) were assayed in 385 ...

Assessment of renal function in patients with hematologic malignancies undergoing bone marrow transplantation

International Nuclear Information System (INIS)

Estorch, M.; Tembl, A.; Camacho, V.; Sancho, G.; Mena, E.; Flotats, A.; Carrio, I.; Keller, A.; Miralbell, R.

2002-01-01

Patients with hematologic malignancies undergoing bone marrow transplantation (BMT) may develop renal insufficiency. Isotopic determinations of glomerular filtration rate (GFR) and effective renal plasma flow (ERPF) are established methods to evaluate renal function. Aim: To asses renal function changes of patients with hematologic malignancies undergoing BMT by measurements of GFR and ERPF using 51Cr-EDTA and 131I-OIH respectively. Methods: Seventy-one patients (mean age 41 years) were studied prospectively. All patients underwent BMT for hematologic malignancies and had previous normal renal function. Their conditioning included chemotherapy and 12 Gy or 13.5 Gy fractionated total body irradiation (TBI). Kidney shielding blocks fabricated after renal opacification with non-ionic, hypo-osmolar contrast medium were used in 21 patients to limit kidney dose to 10 Gy. GFR and ERPF were measured before conditioning and at 4, 12, and 18 months, using 51Cr-EDTA and 131I-OIH respectively. A decrease of 30% in GFR or ERPF, compared with baseline values, was used to define renal insufficiency. The potential influence of patient- and treatment-related variables on renal dysfunction was assessed. Results: At 4 (early) and 12-18 (late) months, a 30% GFR decrease was observed in 54% and 49% of patients, and a 30% ERPF decrease in 44% and 34% of patients, respectively. GFR decrease at 4 months significantly correlated with age (greatest decrease if <40 years), TBI using kidney blocks (kidney shielding to 10 Gy was associated with a higher rate of renal dysfunction at 4 months compared with full TBI dose), and days of treatment with aminoglycosides/vancomycin. ERPF decrease at 4 months was independently related with amphotericin and prostaglandin E1 (PGE1) treatments. GFR and ERPF decrease at 12-18 months correlated with amphotericin and PGE1 treatments. Conclusion: Early post-BMT renal dysfunction is associated with the administration of potentially nephrotoxic drugs. Younger

Renal impairment in a rural African antiretroviral programme

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Lessells Richard J

2009-08-01

Full Text Available Abstract Background There is little knowledge regarding the prevalence and nature of renal impairment in African populations initiating antiretroviral treatment, nor evidence to inform the most cost effective methods of screening for renal impairment. With the increasing availability of the potentially nephrotixic drug, tenofovir, such information is important for the planning of antiretroviral programmes Methods (i Retrospective review of the prevalence and risk factors for impaired renal function in 2189 individuals initiating antiretroviral treatment in a rural African setting between 2004 and 2007 (ii A prospective study of 149 consecutive patients initiating antiretrovirals to assess the utility of urine analysis for the detection of impaired renal function. Severe renal and moderately impaired renal function were defined as an estimated GFR of ≤ 30 mls/min/1.73 m2 and 30–60 mls/min/1.73 m2 respectively. Logistic regression was used to determine odds ratio (OR of significantly impaired renal function (combining severe and moderate impairment. Co-variates for analysis were age, sex and CD4 count at initiation. Results (i There was a low prevalence of severe renal impairment (29/2189, 1.3% 95% C.I. 0.8–1.8 whereas moderate renal impairment was more frequent (287/2189, 13.1% 95% C.I. 11.6–14.5 with many patients having advanced immunosuppression at treatment initiation (median CD4 120 cells/μl. In multivariable logistic regression age over 40 (aOR 4.65, 95% C.I. 3.54–6.1, male gender (aOR 1.89, 95% C.I. 1.39–2.56 and CD4 Conclusion In this rural African setting, significant renal impairment is uncommon in patients initiating antiretrovirals. Urine analysis alone may be inadequate for identification of those with impaired renal function where resources for biochemistry are limited.

An experimental study on recovery of renal function using {sup 99m}Tc DMSA scintigram after percutaneous nephrostomy in unilateral hydronephrosis

Energy Technology Data Exchange (ETDEWEB)

Moon, Tae Yong; Nam, Sang Hwa; Park, Jong Yeon; Kim, Byung Soo [College of Medicine, Pusan National University, Pusan (Korea, Republic of)

1992-07-15

Obstruction on the urinary tract eventually results in damage to the kidneys and lose of function. The questions that concern the clinician are the degree of nephron loss in that kidney and potential for recovery following the relief of obstruction. {sup 99m}Tc DMSA accumulates in tubule cells and has been proposed as a marker of the tubular mass. The authors estimated the renal uptake ratio of {sup 99m}Tc DMSA for the degree of nephron loss corresponding to duration of hydronephrosis following left ureteral ligation in 5 New Zealand white rabbits and the potential for recovery following percutaneous nephrostomy of hydronephrosis in 24 rabbits. While the renal uptake ratio of {sup 99m}Tc DMSA of the kidney with unilateral hydronephrosis following ureteral ligation reduced dramatically within 24 hour, that of the opposite healthy kidney increased, and the total renal uptake ratio was same as normal functioning kidneys before ureteral ligation. Upon ureteral release, there was no evidence of definite recovery or impairment in the experimental kidneys for 5 days. The authors conclude that a combination of ureteral release and administration of some drugs such as renal vasodilator or diuretics is an appropriate treatment for the recovery of function in unilateral hydronephrosis.

Several issues regarding evaluation of renal injury and renal insufficiency in patients with liver disease

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HAO Kunyan

2016-07-01

Full Text Available In patients with liver disease such as viral hepatitis and liver cirrhosis, renal injury and renal insufficiency can be generally classified as acute kidney injury (AKI, chronic kidney disease, and acute-on-chronic nephropathy. AKI can be classified as stage 1 (risk stage, stage 2 (injury stage, and stage 3 (failure stage. Traditionally hepatorenal syndrome is classified as types Ⅰ and Ⅱ, and in recent years, type Ⅲ hepatorenal syndrome with organic renal injury has been proposed. Hepatorenal disorder(HRD is used to describe any renal disease which occurs in patients with liver cirrhosis. At present, sensitive and accurate biochemical parameters used to evaluate renal function in patients with liver disease in clinical practice include estimated glomerular filtration rate, increase in serum creatinine within unit time, and serum cystatin C level, and urinary microalbumin level also plays an important role in the early diagnosis of nephropathy. Causes of liver disease, severity, complications including infection, nutritional status, therapeutic drugs, and underlying nephropathy may be associated with renal injury and renal insufficiency in patients with liver disease and should be differentiated.

Multiple Renal Artery Pseudoaneurysms in Patients Undergoing Renal Artery Embolization Following Partial Nephrectomy: Correlation with RENAL Nephrometry Scores

International Nuclear Information System (INIS)

Gupta, Nakul; Patel, Anish; Ensor, Joe; Ahrar, Kamran; Ahrar, Judy; Tam, Alda; Odisio, Bruno; Huang, Stephen; Murthy, Ravi; Mahvash, Armeen; Avritscher, Rony; McRae, Stephen; Sabir, Sharjeel; Wallace, Michael; Matin, Surena; Gupta, Sanjay

2017-01-01

PurposeTo describe the incidence of multiple renal artery pseudoaneurysms (PSA) in patients referred for renal artery embolization following partial nephrectomy and to study its relationship to RENAL nephrometry scores.Materials and MethodsThe medical records of 25 patients referred for renal artery embolization after partial nephrectomy were retrospectively reviewed for the following parameters: size and number of tumors, RENAL nephrometry scores, angiographic abnormalities, technical and clinical outcomes, and estimated glomerular filtration rates (eGFRs) after embolization.ResultsTwenty-four patients had primary renal tumors, while 1 patient had a pancreatic tumor invading the kidney. Multiple tumors were resected in 4 patients. Most patients (92 %) were symptomatic, presenting with gross hematuria, flank pain, or both. Angiography revealed PSA with (n = 5) or without (n = 20) AV fistulae. Sixteen patients (64 %) had multiple PSA involving multiple renal vessels. Higher RENAL nephrometry scores were associated with an increasing likelihood of multiple PSA. Multiple vessels were embolized in 14 patients (56 %). Clinical success was achieved after one (n = 22) or two (n = 3) embolization sessions in all patients. Post-embolization eGFR values at different time points after embolization were not significantly different from the post-operative eGFR.ConclusionA majority of patients requiring renal artery embolization following partial nephrectomy have multiple pseudoaneurysms, often requiring selective embolization of multiple vessels. Higher RENAL nephrometry score is associated with an increasing likelihood of multiple pseudoaneurysms. We found transarterial embolization to be a safe and effective treatment option with no long-term adverse effect on renal function in all but one patient with a solitary kidney.

Multiple Renal Artery Pseudoaneurysms in Patients Undergoing Renal Artery Embolization Following Partial Nephrectomy: Correlation with RENAL Nephrometry Scores

Energy Technology Data Exchange (ETDEWEB)

Gupta, Nakul [Houston Methodist Hospital (United States); Patel, Anish [The University of Texas Southwestern Medical Center (United States); Ensor, Joe [Houston Methodist Research Institute, The Houston Methodist Cancer Center (United States); Ahrar, Kamran; Ahrar, Judy; Tam, Alda; Odisio, Bruno; Huang, Stephen; Murthy, Ravi; Mahvash, Armeen; Avritscher, Rony; McRae, Stephen; Sabir, Sharjeel; Wallace, Michael [The University of Texas MD Anderson Cancer Center, Department of Interventional Radiology (United States); Matin, Surena [The University of Texas MD Anderson Cancer Center, Department of Urology (United States); Gupta, Sanjay, E-mail: sgupta@mdanderson.org [The University of Texas MD Anderson Cancer Center, Department of Interventional Radiology (United States)

2017-02-15

PurposeTo describe the incidence of multiple renal artery pseudoaneurysms (PSA) in patients referred for renal artery embolization following partial nephrectomy and to study its relationship to RENAL nephrometry scores.Materials and MethodsThe medical records of 25 patients referred for renal artery embolization after partial nephrectomy were retrospectively reviewed for the following parameters: size and number of tumors, RENAL nephrometry scores, angiographic abnormalities, technical and clinical outcomes, and estimated glomerular filtration rates (eGFRs) after embolization.ResultsTwenty-four patients had primary renal tumors, while 1 patient had a pancreatic tumor invading the kidney. Multiple tumors were resected in 4 patients. Most patients (92 %) were symptomatic, presenting with gross hematuria, flank pain, or both. Angiography revealed PSA with (n = 5) or without (n = 20) AV fistulae. Sixteen patients (64 %) had multiple PSA involving multiple renal vessels. Higher RENAL nephrometry scores were associated with an increasing likelihood of multiple PSA. Multiple vessels were embolized in 14 patients (56 %). Clinical success was achieved after one (n = 22) or two (n = 3) embolization sessions in all patients. Post-embolization eGFR values at different time points after embolization were not significantly different from the post-operative eGFR.ConclusionA majority of patients requiring renal artery embolization following partial nephrectomy have multiple pseudoaneurysms, often requiring selective embolization of multiple vessels. Higher RENAL nephrometry score is associated with an increasing likelihood of multiple pseudoaneurysms. We found transarterial embolization to be a safe and effective treatment option with no long-term adverse effect on renal function in all but one patient with a solitary kidney.

Computed Tomography Volumetry in Preoperative Living Kidney Donor Assessment for Prediction of Split Renal Function.

Science.gov (United States)

Wahba, Roger; Franke, Mareike; Hellmich, Martin; Kleinert, Robert; Cingöz, Tülay; Schmidt, Matthias C; Stippel, Dirk L; Bangard, Christopher

2016-06-01

Transplant centers commonly evaluate split renal function (SRF) with Tc-99m-mercapto-acetyltriglycin (MAG3) scintigraphy in living kidney donation. Alternatively, the kidney volume can be measured based on predonation CT scans. The aim of this study was to identify the most accurate CT volumetry technique for SRF and the prediction of postdonation kidney function (PDKF). Three CT volumetry techniques (modified ellipsoid volume [MELV], smart region of interest [ROI] volume, renal cortex volume [RCV]) were performed in 101 living kidney donors. Preoperation CT volumetric SRF was determined and compared with MAG3-SRF, postoperation donor kidney function, and graft function. The correlation between donors predonation total kidney volume and predonation kidney function was the highest for RCV (0.58 with creatine clearance, 0.54 with estimated glomerular filtration rate-Cockcroft-Gault). The predonation volume of the preserved kidney was (ROI, MELV, RCV) 148.0 ± 29.1 cm, 151.2 ± 35.4 and 93.9 ± 25.2 (P volumetry SRF and MAG3-SRF (bias, 95% limits of agreement: ROI vs MAG3 0.4%, -7.7% to 8.6%; MELV vs MAG3 0.4%, -8.9% to 9.7%; RCV vs MAG3 0.8%, -9.1% to 10.7%). The correlation between predonation CT volumetric SRF of the preserved kidney and PDKF at day 3 was r = 0.85 to 0.88, between MAG3-SRF and PDKF (r = 0.84). The difference of predonation SRF between preserved and donated kidney was the lowest for ROI and RCV (median, 3% and 4%; 95th percentile, 9% and 13%). Overall renal cortex volumetry seems to be the most accurate technique for the evaluation of predonation SRF and allows a reliable prediction of donor's PDKF.

Radioindication of hemodynamics and functional state of parenchyma of the kidneys in stenosis of renal arteries

International Nuclear Information System (INIS)

Efimov, O.N.; Gabuniya, R.I.; Kamynin, Yu.F.; Matveenko, E.G.; Buyuklyan, A.N.; Skoropad, L.S.; Syzgantseva, L.M.

1978-01-01

Hemodynamics and functional state of parenchyma of the kidney were studied in 39 patients with stenosis of the renal arteries by means of pertechnetate 99 Tc, hippuran 131 I and chlormerodrine 197 Hg. In patients with vasorenal hypertension the following changes in the stenosed kidney were revealed: a significant decrease in the renal blood flow, renal fraction, volume of maximal saturation, specific blood flow, systolic renal index; elevation of the intrarenal vascular resistance; and impairment of the functional state of the renal parenchyma. It was established that there was a direct dependence between the renal blood flow and the volume of maximal saturation and a reverse dependence between the renal blood flow and intrarenal vascular resistance. Hemodynamic changes in the stenosed kidney played an important role and led at first to a bias in renographic indices and then - to a decrease in accumulation of chlormerodrine 197 Hg in the kidneys. It was noted that changes in the functional state of the renal parenchyma tended to be dependent upon the level of the renal blood flow, and indices of the renal blood flow - upon the values of arterial pressure. From diagnostic point of view, methods of radioiangiography, as compared with renography and scintigraphy, were found to be the most informative

Effects of Bosutinib Treatment on Renal Function in Patients With Philadelphia Chromosome-Positive Leukemias.

Science.gov (United States)

Cortes, Jorge E; Gambacorti-Passerini, Carlo; Kim, Dong-Wook; Kantarjian, Hagop M; Lipton, Jeff H; Lahoti, Amit; Talpaz, Moshe; Matczak, Ewa; Barry, Elly; Leip, Eric; Brümmendorf, Tim H; Khoury, H Jean

2017-10-01

The purpose of the study was to assess renal function in patients with Philadelphia chromosome-positive leukemias receiving bosutinib or imatinib. Patients received first-line bosutinib (n = 248) or imatinib (n = 251; phase III trial), or second-line or later bosutinib (phase I/II trial; n = 570). Adverse events (AEs) and changes from baseline in estimated glomerular filtration rate (eGFR) and serum creatinine were assessed. Time from the last patient's first dose to data cutoff was ≥ 48 months. Renal AEs were reported in 73/570 patients (13%) receiving second-line or later bosutinib, and in 22/248 (9%) and 16/251 (6%) receiving first-line bosutinib and imatinib, respectively. eGFR in patients receiving bosutinib declined over time with more patients developing Grade ≥ 3b eGFR (570, 24%) compared with first-line bosutinib (26/248, 10%) and imatinib (25/251, 10%); time to Grade ≥ 3b eGFR was shortest with second-line or later bosutinib. Similar proportions of patients receiving second-line or later bosutinib (74/139, 53%), first-line bosutinib (15/26, 58%), and first-line imatinib (15/25, 60%) improved to ≥ 45 mL/min/1.73 m 2 eGFR as of the last follow-up. In a regression analysis, first-line treatment with bosutinib versus imatinib was not a significant predictor of Grade ≥ 3b eGFR. Long-term bosutinib treatment is associated with an apparently reversible decline in renal function with frequency and characteristics similar to renal decline observed with long-term imatinib treatment. Patients with risk factors for Grade ≥ 3b eGFR should be monitored closely. Copyright © 2017 Elsevier Inc. All rights reserved.

The effect of obesity and type 1 diabetes on renal function in children and adolescents.

Science.gov (United States)

Franchini, Simone; Savino, Alessandra; Marcovecchio, M Loredana; Tumini, Stefano; Chiarelli, Francesco; Mohn, Angelika

2015-09-01

Early signs of renal complications can be common in youths with type 1 diabetes (T1D). Recently, there has been an increasing interest in potential renal complications associated with obesity, paralleling the epidemics of this condition, although there are limited data in children. Obese children and adolescents present signs of early alterations in renal function similar to non-obese peers with T1D. Eighty-three obese (age: 11.6 ± 3.0 yr), 164 non-obese T1D (age: 12.4 ± 3.2 yr), and 71 non-obese control (age: 12.3 ± 3.2 yr) children and adolescents were enrolled in the study. Anthropometric parameters and blood pressure were measured. Renal function was assessed by albumin excretion rate (AER), serum cystatin C, creatinine and estimated glomerular filtration rate (e-GFR), calculated using the Bouvet's formula. Obese and non-obese T1D youths had similar AER [8.9(5.9-10.8) vs. 8.7(5.9-13.1) µg/min] and e-GFR levels (114.8 ± 19.6 vs. 113.4 ± 19.1 mL/min), which were higher than in controls [AER: 8.1(5.9-8.7) µg/min, e-GFR: 104.7 ± 18.9 mL/min]. Prevalence of microalbuminuria and hyperfiltration was similar between obese and T1D youths and higher than their control peers (6.0 vs. 8.0 vs. 0%, p = 0.02; 15.9 vs. 15.9 vs. 4.3%, p = 0.03, respectively). Body mass index (BMI) z-score was independently related to e-GFR (r = 0.328; p 1), and AER (r = 0.138; p = 0.017). Hemoglobin A1c (HbA1c) correlated with AER (r = 0.148; p = 0.007) but not with eGFR (r = 0.041; p = 0.310). Obese children and adolescents show early alterations in renal function, compared to normal weight peers, and they have similar renal profiles than age-matched peers with T1D. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Serum Levels of the Adipokine Progranulin Depend on Renal Function

Science.gov (United States)

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

2013-01-01

OBJECTIVE Progranulin has recently been introduced as a novel adipokine inducing insulin resistance and obesity. In the current study, we investigated renal elimination, as well as association of the adipokine with markers of the metabolic syndrome. RESEARCH DESIGN AND METHODS Progranulin serum levels were quantified by enzyme-linked immunosorbent assay and correlated to anthropometric and biochemical parameters of renal function and glucose and lipid metabolism, as well as inflammation, in 532 patients with stages 1–5 of chronic kidney disease (CKD). RESULTS Median serum progranulin levels adjusted for age, sex, and BMI were significantly different between CKD stages with highest values detectable in stage 5 (stage 1, 58.3 µg/L; stage 2, 63.0 µg/L; stage 3, 65.4 µg/L; stage 4, 68.8 µg/L; and stage 5, 90.6 µg/L). Furthermore, CKD stage was the strongest independent predictor of circulating progranulin in our cohort. In addition, high-sensitivity interleukin-6 and adiponectin remained significantly and independently correlated with the adipokine. CONCLUSIONS We demonstrate that progranulin serum levels increase with deteriorating renal function. These findings are in accordance with the hypothesis that renal clearance is a major elimination route for circulating progranulin. Furthermore, the adipokine is positively and independently associated with markers of inflammation and adiponectin. PMID:23033238

Dynamic autoregulation and renal injury in Dahl rats

DEFF Research Database (Denmark)

Karlsen, F M; Andersen, C B; Leyssac, P P

1997-01-01

of hypertension, a gradual impairment of autoregulatory control of renal blood flow might expose the glomerular circulation to periods of elevated pressure, resulting in renal injuries in Dahl S rats. Dynamic autoregulatory capacity was assessed in Dahl S and Dahl salt-resistant (Dahl R) rats, SHR, and Sprague......-Dawley rats by inducing broad-band fluctuations in the arterial blood pressure and simultaneously measuring renal blood flow. Dynamic autoregulation was estimated by the transfer function using blood pressure as the input and renal blood flow as the output. Renal morphological injuries were evaluated in Dahl......The Dahl salt-sensitive (Dahl S) rat develops hypertension and renal injuries when challenged with a high salt diet and has been considered to be a model of chronic renal failure. Renal injuries appear very early in life compared with the spontaneously hypertensive rat (SHR). During the course...

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

DEFF Research Database (Denmark)

Kamper, A L

1991-01-01

studies have been published to date. In chronic renal failure, ACE inhibitors may worsen anaemia and hyperkalaemia. Renovascular hypertension can be treated with ACE inhibitors, but the treatment may lead to a compromised renal function. The dosage of these drugs should be reduced in renal failure...

Echo and BNP serial assessment in ambulatory heart failure care: Data on loop diuretic use and renal function

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Frank Lloyd Dini

2016-12-01

Full Text Available We compared the follow-up data on loop diuretic use and renal function, as assessed by serum creatinine levels, and the estimated glomerular filtration rate (eGFR, of two groups of consecutive ambulatory HF patients: 1 the clinically-guided group, in which management was clinically driven based on the institutional protocol of the HF Unit of the Cardiovascular and Thoracic Department of Pisa (standard of care and 2 the echo and B-type natriuretic peptide (BNP guided group (patients conforming to the protocol of the Network Labs Ultrasound (NEBULA in HF Study Group: Pisa, Perugia, Pavia; Verona, Auckland, and Veruno, in which therapy was delivered according to the serial assessment of BNP and echocardiography. Patients whose follow-up was based on standard of care had a significant higher prevalence of worsening renal function, that was likely related to higher diuretic dosages, whilst, a better management of renal function was observed in the echo-BNP-guided group. The data is related to “Echo and natriuretic peptide guided therapy improves outcome and reduces worsening renal function in systolic heart failure: An observational study of 1137 outpatients” (A. Simioniuc, E. Carluccio, S. Ghio, A. Rossi, P. Biagioli, G. Reboldi, G.G. Galeotti, F. Lu, C. Zara, G. Whalley, P.G. Temporelli, F.L. Dini, 2016; K.J. Harjai, H.K. Dinshaw, E. Nunez, M. Shah, H. Thompson, T. Turgut, H.O. Ventura, 1999; A. Ahmed, A. Husain, T.E. Love, G. Gambassi, L.J. Dell׳Italia, G.S. Francis, M. Gheorghiade, R.M. Allman, S. Meleth, R.C. Bourge, 2006 [1–3].

Tobacco Induced Renal Function Alterations in Wistar Rats: An 8 ...

African Journals Online (AJOL)

... pattern was observed for urea and uric acid levels. Over all, the significant increase (P<0.05) in renal function parameters of the test rats (as compared to the control values), suggests that the ingestion of tobacco snuff has harmful effects on kidney functions. Keywords: Tobacco, Snuff, Kidney function, Nicotine substitute.

Cigarette smoking and cardio-renal events in patients with atherosclerotic renal artery stenosis.

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Christopher A Drummond

Full Text Available Cigarette smoking causes cardiovascular disease and is associated with poor kidney function in individuals with diabetes mellitus and primary kidney diseases. However, the association of smoking on patients with atherosclerotic renal artery stenosis has not been studied. The current study utilized data from the Cardiovascular Outcomes in Renal Atherosclerotic Lesions (CORAL, NCT00081731 clinical trial to evaluate the effects of smoking on the risk of cardio-renal events and kidney function in this population. Baseline data showed that smokers (n = 277 out of 931 were significantly younger at enrollment than non-smokers (63.3±9.1 years vs 72.4±7.8 years; p<0.001. In addition, patients who smoke were also more likely to have bilateral renal artery stenoses and peripheral vascular disease (PVD. Longitudinal analysis showed that smokers experienced composite endpoint events (defined as first occurrence of: stroke; cardiovascular or renal death; myocardial infarction; hospitalization for congestive heart failure; permanent renal replacement; and progressive renal insufficiency defined as 30% reduction of GFR from baseline sustained for ≥ 60 days at a substantially younger age compared to non-smokers (67.1±9.0 versus 76.1±7.9, p<0.001. Using linear regression and generalized linear modeling analysis controlled by age, sex, and ethnicity, smokers had significantly higher cystatin C levels (1.3±0.7 vs 1.2±0.9, p<0.01 whereas creatinine and estimated glomerular filtration rate (eGFR were not different from non-smokers. From these data we conclude that smoking has a significant association with deleterious cardio-renal outcomes in patients with renovascular hypertension.

Renal function and carotid atherosclerosis in adults with no known kidney disease.

Science.gov (United States)

Buscemi, S; Geraci, G; Massenti, F M; Buscemi, C; Costa, F; D'Orio, C; Rosafio, G; Buscemi, C; Maniaci, V; Parrinello, G

2017-03-01

A high prevalence of atherosclerotic lesions characterizes patients with chronic kidney disease, though there is little data on the relationship between kidney function and atherosclerotic changes in the healthy population or in people with no known renal impairment. The aim of our study was to analyze, in a comprehensive general population with no known kidney disease, the relationship between renal function and subclinical carotid atherosclerotic damage. A general real-life population of 611 participants (233 males and 378 females; age ≥18 years) with no known kidney failure was selected for the study. The glomerular filtration rate (GFR) was estimated according to the CKD-EPI equation. Carotid intima-media thickness (c-IMT) and plaques were assessed by duplex Doppler ultrasonography of the carotid vessels. The main laboratory and metabolic parameters were evaluated in all participants. When we divided the overall study population into tertiles according to GFR values (I tertile 99 ml/min/1.73 m 2 ), the c-IMT mean values and the prevalence of carotid plaques decreased with the increasing tertile of GFR. On univariate analysis, c-IMT was significantly correlated with eGFR (r = -0.33; p < 0.001), serum creatinine (r = 0.17; p < 0.001), and other variables such as age, systolic blood pressure, waist circumference, fasting or random glycemia, and glycated hemoglobin (HbA 1 c). On multiple regression analysis, serum creatinine was associated with c-IMT (β = 0.069; p = 0.017), independent of other covariates. Our study seems to suggest the importance of early identification of people with near normal or mildly decreased renal function due to its association with carotid atherosclerosis. Copyright © 2016 The Italian Society of Diabetology, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition, and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights

High prevalence and associated risk factors for impaired renal function and urinary abnormalities in a rural adult population from southern China.

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Qinghua Liu

Full Text Available BACKGROUND: The prevalence of chronic kidney disease (CKD has increased and will continue to rise worldwide. However, data regarding the prevalence of CKD in a rural area of China are limited. We therefore investigated the prevalence and associated risk factors of impaired renal function and urinary abnormalities in an adult rural population in southern China. METHODS: Between December 2006 and January 2007, residents older than 20 years from four villages in Zhuhai city were randomly selected using a stratified, multistage sampling technique. All participants were interviewed and tested for hematuria, albuminuria and estimated glomerular filtration rate (eGFR. The associations between age, gender, diabetes mellitus, hypertension, hyperuricemia, education level and indicators of renal damage were examined. RESULTS: Overall, 1,214 subjects were enrolled in this study. After adjustment for age and gender, the prevalence of albuminuria was 7.1% (95% CI: 4.5, 8.1, reduced eGFR was 2.6% (95% CI: 1.7%, 3.3%, and hematuria was 4.6% (95% CI: 3.3%, 6.0%. Approximately 13.6% (95% CI: 12.0%, 15.1% of the patients had at least one indicator of renal damage, but only 8.3% were previously aware. Age, diabetes, hyperlipidemia, hypertension, hyperuricemia, use of nephrotoxic medications, coronary heart disease and history of CKD were independently associated with impaired renal function and urinary abnormalities. Additionally, age, diabetes, and hypertension were independently associated with albuminuria. Age, hypertension, hyperuricemia, central obesity, and coronary heart disease were independently associated with reduced renal function. CONCLUSIONS: The high prevalence and low awareness of impaired renal function and urinary abnormalities in this population illustrates the urgent need to implement a CKD prevention program in the rural areas of southern China.

Health status, renal function, and quality of life after multiorgan failure and acute kidney injury requiring renal replacement therapy

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Faulhaber-Walter R

2016-05-01

Full Text Available Robert Faulhaber-Walter,1,2 Sebastian Scholz,1,3 Herrmann Haller,1 Jan T Kielstein,1,* Carsten Hafer1,4,* 1Department of Renal and Hypertensive Disease, Medical School Hannover, Hannover, Germany; 2Facharztzentrum Aarberg, Waldshut-Tiengen, Germany; 3Sanitaetsversorgungszentrum Wunstorf, Wunstorf, Germany; 4HELIOS Klinikum Erfurt, Erfurt, Germany *These authors contributed equally to this work Background: Critically ill patients with acute kidney injury (AKI in need of renal replacement therapy (RRT may have a protracted and often incomplete rehabilitation. Their long-term outcome has rarely been investigated. Study design: Survivors of the HANnover Dialysis OUTcome (HANDOUT study were evaluated after 5 years for survival, health status, renal function, and quality of life (QoL. The HANDOUT study had examinded mortality and renal recovery of patients with AKI receiving either standard extendend or intensified dialysis after multi organ failure. Results: One hundred fifty-six former HANDOUT participants were analyzed. In-hospital mortality was 56.4%. Five-year survival after AKI/RRT was 40.1% (86.5% if discharged from hospital. Main causes of death were cardiovascular complications and sepsis. A total of 19 survivors presented to the outpatient department of our clinic and had good renal recovery (mean estimated glomerular filtration rate 72.5±30 mL/min/1.73 m2; mean proteinuria 89±84 mg/d. One person required maintenance dialysis. Seventy-nine percent of the patients had a pathological kidney sonomorphology. The Charlson comorbidity score was 2.2±1.4 and adjusted for age 3.3±2.1 years. Numbers of comorbid conditions averaged 2.38±1.72 per patient (heart failure [52%] > chronic kidney disease/myocardial infarction [each 29%]. Median 36-item short form health survey (SF-36™ index was 0.657 (0.69 physical health/0.66 mental health. Quality-adjusted life-years after 5 years were 3.365. Conclusion: Mortality after severe AKI is higher than

Effect of methanol leaf extract of Dalbergia saxatilis Hook.f (fabaceae on renal function

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Fatima Ismail Hassan

2016-11-01

Full Text Available Objective: Dalbegia saxatilis (D.saxatilis is used as a decoction in traditional medicine for ailments such as cough, small pox, skin lesions, bronchial ailments and toothache. This study is aimed at evaluating the toxic effect of methanol leaf extract of D.saxatilis on renal function. Materials and Methods: Wistar rats of both sexes were divided into four groups of five: control animals (group 1 received distilled water 1 ml/kg while groups 2, 3 and 4 were given graded doses of the extract (250, 500 and 1000 mg/kg body weight, respectively daily for 28 days. Body weight changes were estimated by weighing the rats twice weekly using digital weighing balance. After 28 days, blood samples were obtained for evaluation of renal indices and the kidney was used for histopathology. Data were analysed using one–way and repeated measures ANOVA using SPSS version 20. Results: Significant weight increase in all groups were observed (p

Predictors of renal function recovery among patients undergoing renal replacement therapy following orthotopic liver transplantation.

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Andreoli, Maria Claudia Cruz; Souza, Nádia Karina Guimarães de; Ammirati, Adriano Luiz; Matsui, Thais Nemoto; Carneiro, Fabiana Dias; Ramos, Ana Claudia Mallet de Souza; Iizuca, Ilson Jorge; Coelho, Maria Paula Vilela; Afonso, Rogério Carballo; Ferraz-Neto, Ben-Hur; Almeida, Marcio Dias de; Durão, Marcelino; Batista, Marcelo Costa; Monte, Julio Cesar; Pereira, Virgílio Gonçalves; Santos, Oscar Pavão Dos; Santos, Bento Cardoso Dos

2017-01-01

Renal dysfunction frequently occurs during the periods preceding and following orthotopic liver transplantation (OLT), and in many cases, renal replacement therapy (RRT) is required. Information regarding the duration of RRT and the rate of kidney function recovery after OLT is crucial for transplant program management. We evaluated a sample of 155 stable patients undergoing post-intensive care hemodialysis (HD) from a patient population of 908 adults who underwent OLT. We investigated the average time to renal function recovery (duration of RRT required) and determined the risk factors for remaining on dialysis > 90 days after OLT. Log-rank tests were used for univariate analysis, and Cox proportional hazards models were used to identify factors associated with the risk of remaining on HD. The results of our analysis showed that of the 155 patients, 28% had pre-OLT diabetes mellitus, 21% had pre-OLT hypertension, and 40% had viral hepatitis. Among the patients, the median MELD (Model for End-Stage Liver Disease) score was 27 (interquartile range [IQR] 22-35). When they were listed for liver transplantation, 32% of the patients had serum creatinine (Scr) levels > 1.5 mg/dL or were on HD, and 50% had serum creatinine (Scr) levels > 1.5 mg/dL or were on HD at the time of OLT. Of the transplanted patients, 25% underwent pre-OLT intermittent HD, and 14% and 41% underwent continuous renal replacement therapy (CRRT) pre-OLT and post-OLT, respectively. At 90 days post-OLT, 118 (76%) patients had been taken off dialysis, and 16 (10%) patients had died while undergoing HD. The median recovery time of these post-OLT patients was 33 (IQR 27-39) days. In the multivariate analysis, fulminant hepatic failure as the cause of liver disease (prenal function after OLT, and those who were diagnosed with fulminant hepatic failure, had no pre-OLT hypertension, received a lower transfused volume of intraoperative FFP and did not undergo pre-OLT intermittent HD had a higher probability

Improving the measurement of longitudinal change in renal function: automated detection of changes in laboratory creatinine assay

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Norman Poh

2015-04-01

Full Text Available IntroductionRenal function is reported using the estimates of glomerular filtration rate (eGFR. However, eGFR values are recorded without reference to the particular serum creatinine (SCr assays used to derive them, and newer assays were introduced at different time points across the laboratories in the United Kingdom. These changes may cause systematic bias in eGFR reported in routinely collected data, even though laboratory-reported eGFR values have a correction factor applied.DesignAn algorithm to detect changes in SCr that in turn affect eGFR calculation method was developed. It compares the mapping of SCr values on to eGFR values across a time series of paired eGFR and SCr measurements.SettingRoutinely collected primary care data from 20,000 people with the richest renal function data from the quality improvement in chronic kidney disease trial.ResultsThe algorithm identified a change in eGFR calculation method in 114 (90% of the 127 included practices. This change was identified in 4736 (23.7% patient time series analysed. This change in calibration method was found to cause a significant step change in the reported eGFR values, producing a systematic bias. The eGFR values could not be recalibrated by applying the Modification of Diet in Renal Disease equation to the laboratory reported SCr values.ConclusionsThis algorithm can identify laboratory changes in eGFR calculation methods and changes in SCr assay. Failure to account for these changes may misconstrue renal function changes over time. Researchers using routine eGFR data should account for these effects.  

Association of Transcatheter Aortic Valve Replacement With 30-Day Renal Function and 1-Year Outcomes Among Patients Presenting With Compromised Baseline Renal Function: Experience From the PARTNER 1 Trial and Registry.

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Beohar, Nirat; Doshi, Darshan; Thourani, Vinod; Jensen, Hanna; Kodali, Susheel; Zhang, Feifan; Zhang, Yiran; Davidson, Charles; McCarthy, Patrick; Mack, Michael; Kapadia, Samir; Leon, Martin; Kirtane, Ajay

2017-07-01

The frequency of baseline renal impairment among high-risk and inoperable patients with severe aortic stenosis undergoing a transcatheter aortic valve replacement (TAVR) and the effect of TAVR on subsequent renal function are, to our knowledge, unknown. To determine the effect of TAVR among patients with baseline renal impairment. This substudy of patients with baseline renal impairment (estimated glomerular filtration rate [eGFR] ≤ 60 mL/min) and paired baseline and 30-day measures of renal function undergoing TAVR in the PARTNER 1 trial and continued access registries was conducted in 25 centers in the United States and Canada. Patients were categorized with improved eGFR (30-day follow-up eGFR≥10% higher than baseline pre-TAVR), worsened eGFR (≥10% lower), or no change in renal function (neither). Baseline characteristics, 30-day to 1-year all-cause mortality, and repeat hospitalization were compared. Multivariable models were constructed to identify predictors of 1-year mortality and of improvement/worsening in eGFR. Of the 821 participants, 401 (48.8%) were women and the mean (SD) age for participants with improved, unchanged, or worsening eGFR was 84.90 (6.91) years, 84.37 (7.13) years, and 85.39 (6.40) years, respectively. The eGFR was 60 mL/min or lower among 821 patients (72%), of whom 345 (42%) improved, 196 (24%) worsened, and 280 (34%) had no change at 30 days. There were no differences in baseline age, body mass index, diabetes, chronic obstructive pulmonary disease, coronary artery disease, peripheral arterial disease, hypertension, pulmonary hypertension, renal or liver disease, New York Heart Association III/IV symptoms, transaortic gradient, left ventricular ejection fraction, or procedural characteristics. The group with improved eGFR had more women, nonsmokers, and a lower cardiac index. Those with worsening eGFR had a higher median Society of Thoracic Surgeons score and left ventricle mass. From 30 days to 1 year, those with improved e

Population pharmacokinetics of pomalidomide in patients with relapsed or refractory multiple myeloma with various degrees of impaired renal function.

Science.gov (United States)

Li, Yan; Wang, Xiaomin; O'Mara, Edward; Dimopoulos, Meletios A; Sonneveld, Pieter; Weisel, Katja C; Matous, Jeffrey; Siegel, David S; Shah, Jatin J; Kueenburg, Elisabeth; Sternas, Lars; Cavanaugh, Chloe; Zaki, Mohamed; Palmisano, Maria; Zhou, Simon

2017-01-01

Pomalidomide is an immunomodulatory drug for treatment of relapsed or refractory multiple myeloma (rrMM) in patients who often have comorbid renal conditions. To assess the impact of renal impairment on pomalidomide exposure, a population pharmacokinetics (PPK) model of pomalidomide in rrMM patients with various degrees of impaired renal function was developed. Intensive and sparse pomalidomide concentration data collected from two clinical studies in rrMM patients with normal renal function, moderately impaired renal function, severely impaired renal function not requiring dialysis, and with severely impaired renal function requiring dialysis were pooled over the dose range of 2 to 4 mg, to assess specifically the influence of the impaired renal function as a categorical variable and a continuous variable on pomalidomide clearance and plasma exposure. In addition, pomalidomide concentration data collected on dialysis days from both the withdrawal (arterial) side and from the returning (venous) side of the dialyzer, from rrMM patients with severely impaired renal function requiring dialysis, were used to assess the extent to which dialysis contributes to the removal of pomalidomide from blood circulation. PPK analyses demonstrated that moderate to severe renal impairment not requiring dialysis has no influence on pomalidomide clearance or plasma exposure, as compared to those patients with normal renal function, while pomalidomide exposure increased approximately 35% in patients with severe renal impairment requiring dialysis on nondialysis days. In addition, dialysis increased total body pomalidomide clearance from 5 L/h to 12 L/h, indicating that dialysis will significantly remove pomalidomide from the blood circulation. Thus, pomalidomide should be administered post-dialysis on the days of dialysis.

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

International Nuclear Information System (INIS)

Chachati, A.; Meyers, A.; Rigo, P.; Godon, J.P.

1986-01-01

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

Efficacy of percutaneous transluminal renal angioplasty with stent in elderly male patients with atherosclerotic renal artery stenosis

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Zhao J

2012-10-01

Full Text Available Jiahui Zhao, Qingli Cheng, Xiaoying Zhang, Meihua Li, Sheng Liu, Xiaodan WangDepartment of Geriatric Nephrology, Chinese PLA General Hospital, Beijing, ChinaObjectives: Percutaneous transluminal renal angioplasty with stent implantation (PTRAS has become the treatment of choice for atherosclerotic renal artery stenosis (ARAS. This study evaluates the long-term effects of PTRAS on hypertension and renal function in elderly patients with ARAS.Methods: We conducted a retrospective cohort study of all patients who underwent PTRAS in the geriatric division of a tertiary medical center during the period 2003–2010. The clinical data were extracted from the medical records of each patient. Changes in blood pressure, antihypertensive treatment, and estimated glomerular filtration rate were analyzed before and after PTRAS.Results: Eighty-six stents in 81 elderly patients were placed successfully. The average age of the patients was 76.2 years (65–89 years. Mean follow-up was 31.3 months (range 12 –49 months. There was a significant decrease in both systolic and diastolic blood pressure at the third day after the PTRAS procedure and the reduction in blood pressure was constant throughout the follow-up period until 36 months after PTRAS. However, there was no marked benefit to renal function outcome during the follow-up period. The incidence of contrast-induced nephropathy was 9.9% in this study group. The rate of renal artery restenosis was 14.8%. The survival rate was 96.3% for 4 years after the procedure.Conclusion: It is beneficial to control blood pressure in elderly patients with ARAS up to 36 months after a PTRAS procedure. However, their renal function improvement is limited.Keywords: angioplasty, hypertension, renal function, elderly, renal artery stenosis

Terlipressin improves renal function in patients with cirrhosis and ascites without hepatorenal syndrome

DEFF Research Database (Denmark)

Krag, Aleksander; Møller, Søren; Henriksen, Jens H

2007-01-01

Patients with advanced cirrhosis and ascites are characterized by circulatory dysfunction with splanchnic vasodilatation and renal vasoconstriction, which often lead to ascites. The vasoconstrictor terlipressin improves renal function in hepatorenal syndrome (HRS). The aim of this study...

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

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

2015-05-01

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

Do Clinical Symptoms and Signs Predict Reduced Renal Function ...

African Journals Online (AJOL)

establish chronicity, screening strategies are poorly defined. ... different risk score models. We plotted receiver ... Do you feel that in past 3 months your appetite has reduced ..... index of renal function: New insights into old concepts. Clin.

Post-discharge kidney function is associated with subsequent ten-year renal progression risk among survivors of acute kidney injury.

Science.gov (United States)

Sawhney, Simon; Marks, Angharad; Fluck, Nick; Levin, Adeera; McLernon, David; Prescott, Gordon; Black, Corri

2017-08-01

The extent to which renal progression after acute kidney injury (AKI) arises from an initial step drop in kidney function (incomplete recovery), or from a long-term trajectory of subsequent decline, is unclear. This makes it challenging to plan or time post-discharge follow-up. This study of 14651 hospital survivors in 2003 (1966 with AKI, 12685 no AKI) separates incomplete recovery from subsequent renal decline by using the post-discharge estimated glomerular filtration rate (eGFR) rather than the pre-admission as a new reference point for determining subsequent renal outcomes. Outcomes were sustained 30% renal decline and de novo CKD stage 4, followed from 2003-2013. Death was a competing risk. Overall, death was more common than subsequent renal decline (37.5% vs 11.3%) and CKD stage 4 (4.5%). Overall, 25.7% of AKI patients had non-recovery. Subsequent renal decline was greater after AKI (vs no AKI) (14.8% vs 10.8%). Renal decline after AKI (vs no AKI) was greatest among those with higher post-discharge eGFRs with multivariable hazard ratios of 2.29 (1.88-2.78); 1.50 (1.13-2.00); 0.94 (0.68-1.32) and 0.95 (0.64-1.41) at eGFRs of 60 or more; 45-59; 30-44 and under 30, respectively. The excess risk after AKI persisted over ten years of study, irrespective of AKI severity, or post-episode proteinuria. Thus, even if post-discharge kidney function returns to normal, hospital admission with AKI is associated with increased renal progression that persists for up to ten years. Follow-up plans should avoid false reassurance when eGFR after AKI returns to normal. Copyright © 2017 International Society of Nephrology. Published by Elsevier Inc. All rights reserved.

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

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Suzanne C. Ho

2013-07-01

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

Hypothyroidism presenting as reversible renal impairment: an interesting case report.

Science.gov (United States)

Vikrant, Sanjay; Chander, Subhash; Kumar, Satish; Gupta, Dalip

2013-10-01

We describe an interesting case of reversible renal impairment secondary to hypothyroidism. A 57-years-old man was referred from peripheral institution for evaluation of elevated serum creatinine. He had vague complaints of weakness, lethargy and muscle ache but no urinary symptoms. He was found to have hypothyroidism, and thyroid hormone replacement therapy (THRT) was started which resulted in reversal of the renal dysfunction. There was marked improvement in estimated glomerular filtration rate. 99mTc DTPA renal scans done before and after THRT suggested hypothyroidism responsible for this reversible renal impairment. Several studies have described the pathophysiology of diminished renal function in hypothyroidism. Few studies or case reports have shown total amelioration of renal impairment as seen in our patient. The etiology is presumed to be multifactorial, in which hemodynamic effects and a direct effect of thyroid hormone on the kidney play an important role. We suggest that patients with renal impairment of unknown cause have thyroid function tests undertaken as part of routine investigation.

Interaction of prostaglandins and angiotensin II in the modulation of renal function in congestive heart failure.

Science.gov (United States)

Packer, M

1988-06-01

Despite a dramatic fall in renal blood flow, glomerular filtration rate is usually preserved in patients with congestive heart failure until the terminal stages of the disease. This maintenance of renal function appears to be achieved in part by the synthesis of two vasoactive factors within the kidney--angiotensin II and prostaglandins--which are rapidly released whenever renal perfusion is compromised or sympathetic nerve traffic to the kidneys is increased. Although these two hormonal systems exert opposite effects on systemic and renal blood flow and sodium and water excretion, both act to preserve glomerular filtration rate: prostaglandins by a vasodilator action exerted primarily on the afferent arteriole and angiotensin II by a vasoconstrictor effect on the efferent arteriole. Consequently, when the synthesis of these hormones is experimentally blocked, renal function deteriorates, especially in subjects with marked renal hypoperfusion and sodium depletion; these two factors interact to determine the importance of intrarenal hormonal release in the modulation of renal function. Clinically, four specific factors have been identified that predispose patients with heart failure to the development of functional renal insufficiency after treatment with converting-enzyme or cyclo-oxygenase inhibitors: (1) marked renal hypoperfusion, (2) vigorous diuretic therapy, (3) diabetes mellitus, and (4) intensity of hormonal inhibition within the kidney. This last risk factor may provide the basis for differentiating among enzyme-inhibitory drugs and suggests that renal insufficiency in low-output states may be minimized by the development of therapeutic agents that block hormonal synthesis selectively at sites that are critical to the disease process but spare the homeostatic tissue-based enzyme systems that exist within the kidney.

Quantitative renal cinescintigraphy with iodine-123 hippuran methodological aspects, kit for labeling of hippuran

International Nuclear Information System (INIS)

Mehdaoui, A.; Pecking, A.; Delorme, G.; Mathonnat, F.; Debaud, B.; Bardy, A.; Coornaert, S.; Merlin, L.; Vinot, J.M.; Desgrez, A.; Gambini, D.; Vernejoul, P. de.

1981-08-01

The development of an extemporaneous kit for the labeling of ortho-iodo-hippuric acid (Hippuran) with iodine 123 allows the performance of a routine quantitative renal cinescintigraphy providing in 20 minutes, and in an absolutely non-traumatic way, a very complete renal morphofunctional study including: a cortical renal scintigraphy, sequential scintigraphies of excretory tract, renal functional curves, tubular, global, and separate clearances for each kidney. This functional quantitative investigation method should take a preferential place in the routine renal balance. The methodology of the technique is explained and compared to classical methods for estimation of tubular, global and separate clearances [fr

Resistive index on doppler ultrasound after renal transplantation as renal function predictor

International Nuclear Information System (INIS)

Khan, S.; Baloch, S.

2015-01-01

To determine the correlation between doppler resistive index and serum creatinine levels in renal transplant recipients. Study Design: Cross sectional study. Place and Duration of Study: Department of Radiology, Military Hospital Rawalpindi from Oct 2009 to Oct 2010. Patients and Method: A total of 82 outdoor and admitted patients of both genders, within age group of 18-60 years, were included in the study. These patients were referred from Nephrology department Military Hospital, Rwp and Armed Forces Institute of Urology after renal transplant. Written informed consent was taken along with history of any co-morbid disease like dabetes or hypertension and for post transplant duration. Gray scale ultrasound was performed first, followed by doppler ultrasound of transplanted kidney and resistive index was calculated. The presence of any post transplant complications were also recorded. The values of resistive index were then correlated with the serum creatinine levels. Results: Doppler ultrasound was performed on 82 patients included in the study and resistive index was calculated. A strong correlation between resistive index (RI) and serum creatinine level was found as calculated through Pearson's equation i-e 0.89. Thus making resistive index a strong predictor of transplanted kidney function and survival. Patients with RI>0.8 were older with mean age of 45.56, had raised serum creatinine level with mean value of 276.69 meu mol/l and had longer post transplant duration (mean 21.63 weeks). These patients also had other co-morbid diseases like diabetes mellitus and hypertension. The commonest post transplant complication was raised parenchymal echogenicity (30.5%), followed by perinephric collections (18.3%). Conclusion: RI on doppler ultrasound in renal transplant patients shows a strong correlation with serum creatinine levels. Renal transplant patients with elevated serum creatinine levels had raised resistive indices. (author)

Establishment of frame image in dynamic function renal studies

International Nuclear Information System (INIS)

Guedes, Germano P.; Brunetto, Sergio Q.

1996-01-01

Statistical procedures applied to a set of images of renal function study are described to define a region of interest (ROI) on the kidneys's contours. The kidneys geometry is considered to adapt to the emitting area in every frames

Radiopharmaceuticals for renal studies

International Nuclear Information System (INIS)

Verdera, Silvia

1994-01-01

Between the diagnostic techniques using radiopharmaceuticals in nuclear medicine it find renal studies.A brief description about renal glomerular filtration(GFR) and reliability renal plasma flux (ERPF),renal blood flux measurement agents (RBF),renal scintillation agents and radiation dose estimates by organ physiology was given in this study.tabs

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

DEFF Research Database (Denmark)

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

2002-01-01

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

Difference in long-term prognostic value of renal function between ischemic and non-ischemic mild heart failure

NARCIS (Netherlands)

Smilde, TDJ; Hillege, HL; Navis, G; Voors, AA; Brouwer, J; van Veldhuisen, DJ

2006-01-01

Introduction: Renal function is one of the strongest prognostic markers in patients with chronic heart failure, but it has been suggested that this might be due to (local, i.e. renal) vascular atherosclerosis. The aim of the present study is to evaluate the prognostic value of renal function in both

Renal Osteodystrophy

Directory of Open Access Journals (Sweden)

Aynur Metin Terzibaşoğlu

2004-12-01

Full Text Available Chronic renal insufficiency is a functional definition which is characterized by irreversible and progressive decreasing in renal functions. This impairment is in collaboration with glomeruler filtration rate and serum creatinine levels. Besides this, different grades of bone metabolism disorders develop in chronic renal insufficiency. Pathologic changes in bone tissue due to loss of renal paranchyme is interrelated with calcium, phosphorus vitamine-D and parathyroid hormone. Clinically we can see high turnover bone disease, low turnover bone disease, osteomalacia, osteosclerosis and osteoporosis in renal osteodystropy. In this article we aimed to review pathology of bone metabolism disorders due to chronic renal insufficiency, clinic aspects and treatment approaches briefly.

Non-neoplastic parenchymal changes in kidney cancer and post-partial nephrectomy recovery of renal function.

Science.gov (United States)

Bazzi, Wassim M; Chen, Ling Y; Cordon, Billy H; Mashni, Joseph; Sjoberg, Daniel D; Bernstein, Melanie; Russo, Paul

2015-09-01

To explore the association of non-neoplastic parenchymal changes (nNPC) with patients' health and renal function recovery after partial nephrectomy (PN). This retrospective review identified 800 pT1a patients who underwent PN at Memorial Sloan Kettering Cancer Center from 2007 to 2012. Pathology reports were reviewed for nNPC graded as mild or severe: vascular sclerosis (VS), glomerulosclerosis (GS), and fibrosis/scarring. Correlations between nNPC and known preoperative predictors of renal function [age, sex, African-American race, estimated glomerular filtration rate (eGFR), American Society of Anesthesiologists (ASA) score, body mass index, coronary artery disease, and hypertension (HTN)] were assessed using Spearman's rank correlation (ρ). Multivariable linear regression, adjusted for the described known preoperative risk predictors, was performed to evaluate whether the parenchymal features were able to predict 6-month postoperative eGFR. In this study, 46 % of tumors had benign surrounding parenchyma. We noted statistically significant yet weak associations of VS with age (ρ = 0.19; p < 0.001), ASA (ρ = 0.09; p < 0.001), preoperative eGFR (ρ = -0.14; p < 0.001), and HTN (ρ = 0.14; p < 0.001). GS also significantly correlated with HTN, but the correlation was again small (ρ = 0.12; p < 0.001). After adjusting for known risk predictors, only GS was a significant predictor of 6-month postoperative eGFR. When compared with no GS, mild and severe GS were negatively associated with a decrease of 4.9 and 10.8 mL/min/1.73 m(2) in 6-month postoperative eGFR, respectively. Presence of VS and GS correlated with patients' baseline health, and presence of GS predicted postoperative renal function recovery.

Late renal function following whole abdominal irradiation

International Nuclear Information System (INIS)

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

1996-01-01

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

99m-Tc-aprotinin; a low molecular weight protein for the study of renal function

International Nuclear Information System (INIS)