摘要:

The effect of isotonic mannitol and saline in the early phase of mercuric chloride- (HgCl2-)induced acute renal failure (ARF) in the dog was evaluated. During the first 3 h after HgCl2 alone, glomerular filtration rate (GFR) fell from 1.94 ± 0.14 to 1.04 ± 0.11 and renal blood flow (RBF) from 13.99 ± 1.18 to 7.28 ± 0.77 ml/min·kg BW. Isotonic mannitol alone resulted in a fall of GFR by 22% (p < 0.05 vs. control), but the subsequent administration of HgCl2 could not induce a further fall in GFR and RBF. A similar, if somewhat less pronounced, protective effect was observed when mannitol was started simultaneously with or 2 h after the HgCl2 injection. Infusion of isotonic saline at the same rate as mannitol did not prevent a fall of GFR and RBF from a premercury value of 2.33 ± 0.31 to 1.36 ± 0.26 and 16.83 ± 3.06 to 9.30 ± 2.65 ml/min·kg BW, respectively. In contrast, massive doses of isotonic saline, provoking urinary volume and solute losses comparable to those observed with mannitol, stabilized GFR after HgCl2 at the normal level (ΔGFR = -3%). No relationship between ΔGFR and urinary Hg excretion or renal tissue Hg content could be established. In summary, isotonic mannitol prevented the fall of GFR normally observed in the early phase of HgCl2-induced ARF. This effect was not volume mediated and not due to a higher Hg excretion. The protection was correlated with its osmotic diur

ISSN:1660-8151    

DOI:10.1159/000183307

出版商:S. Karger AG    

年代:1984

数据来源: Karger

摘要:

The present study compares the effect of sodium bicarbonate (LoNaHCO3, Na = 134, HCO3 = 33 mEq/l) and sodium acetate (LoNaAc, Na =134, acetate 33 mEq/l) dialysate on the extravascular fluid mobilization (VFM) and hemodynamic changes in 6 patients during 3 h of hemodialysis with equivalent fluid ultrafiltration of about 600 ml/h. The cumulative decrease in plasma volume after 1, 2 and 3 h of dialysis was significantly less during LoNaHC03 dialysis than during LoNaAc dialysis, with plasma volume almost completely refilled by VFM during the first 2 h of LoNaHCO3 dialysis. High sodium acetate dialysate (HiNaAc, Na = 144, acetate = 33 mEq/l) with equivalent fluid ultrafiltration also resulted in less net decrease in plasma volume and greater VFM than LoNaAc, although the temporal pattern of refilling was somewhat different from that during LoNaHCO3: rapid and complete refilling during the early portion of LoNaHCO3, slower and more progressive refilling during HiNaAc, with similar cumulative refilling for LoNaHCO3 and HiNaAc by 3 h. Mean arterial pressure (MAP) tended to decrease during LoNaAc dialysis, whereas MAP remained stable during LoNaHCO3 and increased slightly during HiNaAc. This study, therefore, suggests that improved hemodynamic stability utilizing bicarbonate dialysate may be due, in part, to greater plasma refilling and better preservation of plasma volume.

ISSN:1660-8151    

DOI:10.1159/000183308

出版商:S. Karger AG    

年代:1984

数据来源: Karger

摘要:

Many previous series reporting the construction of Brescia-Cimino fistulae in children describe a high rate of immediate and late patency failure. Using microsurgery, we have constructed 23 Brescia-Cimino fistulae in 23 children, 10 weighing less than 20 kg and 13 weighing more than 20 kg. An immediate patency rate of 100% was achieved in both weight groups with a late patency rate of 90%-100%, in those under and over 20 kg, respectively. We recommend using microsurgery for all such angioaccess procedures.

ISSN:1660-8151    

DOI:10.1159/000183309

出版商:S. Karger AG    

年代:1984

数据来源: Karger

ISSN:1660-8151    

DOI:10.1159/000183310

出版商:S. Karger AG    

年代:1984

数据来源: Karger

ISSN:1660-8151    

DOI:10.1159/000183311

出版商:S. Karger AG    

年代:1984

数据来源: Karger