摘要:

We have recently reported that administration of the ANF analog A68828 improves renal function in an acute model of postischemic acute renal failure. The current investigation examined the question whether a short-term infusion of A68828 can attenuate the long-term decrement in renal function following an ischemic event. Acute renal failure was induced in male Sprague-Dawley rats (200-250 g) by complete occlusion of both renal arteries for 30 min. During the initial 60 min following ischemia, vehicle (0.1% BSA in saline), A68828 (10µg/kg/min); dopamine (10µg/kg/min); A68828 (10µg/kg/min) plus dopamine (10µg/kg/min); or ANF[1-28] (0.5µg/kg/min) were infused intravenously. In vehicle-treated animals, a very large increase in plasma creatinine was observed, with peak levels at 2 days postischemia (5.5±1.2 mg/dL). A68828 alone, A68828 with dopamine, or ANF[1-28] infusion attenuated the rise in plasma creatinine levels by approximately 50% on each day of the study; dopamine alone was no different from vehicle-treated controls. Gross histological examination of kidneys on the fourth day postischemia revealed that significantly less damage occurred only in the group treated with A68828 alone. These results indicate that infusion of a reduced-size analog of ANF for a brief period in the postischemic kidney improves renal function and lessens tissue damage as evaluated several days after the ischemic event. Furthermore, dopamine infusion provides no discernable beneficial effect.

ISSN:0886-022X    

DOI:10.3109/08860229209039123

出版商:Taylor&Francis    

年代:1992

数据来源: Taylor

摘要:

Daily intraperitoneal (i.p.) injection of genatmicin at a dose of 70 mg/kg for 11 days produced nephrotoxicity in female Sprague-Dawley rats as evidenced by increased excretion of urinary protein and trypsin inhibitory activity as well as rise in renal individual class and total phospholipid. The observed proteinuria was associated with a significant twofold fall in creatinine clearance and histopathological changes, including the presence of hyaline casts and flattened epithelial cells within the lumen of proximal convoluted tubules. Although pyridoxal-5-phosphate (50 mg/kg) administered i.p. did not significantly alter creatinine clearance, histopathology, proteinuria, and urinary trypsin inhibitory activity, an increase in individual class and total phospholipid was noted in kidney. In rats simultaneously administered gentamicin and pyridoxal-5-phosphate, the observed fall in renal gentamicin content was associated with a return of individual class and total phospholipid to control values. However, the decline in creatinine clearance, enhanced proteinuria, and increase in urinary trypsin inhibitory activity in the simultaneous-treated group was similar or greater than that seen in the gentamicin-only injected rats. Morphological examination of simultaneous-treated rats revealed extensive alterations in proximal tubules including numerous mitotic figures, large vesicular nucleii, and prominent nucleoli in epithelial cells as well as hyaline casts within the lumen. Our data combined with results of previous studies suggest that sex and type of rat strain are important factors in aminoglycoside-induced nephrotoxicity. It is evident that a specific concentration of pyridoxal-5-phosphate may be necessary to provide protection against all manifestations of aminoglycoside-induced renal damage.

ISSN:0886-022X    

DOI:10.3109/08860229209039124

出版商:Taylor&Francis    

年代:1992

数据来源: Taylor

摘要:

Puromycin aminonucleoside (PAN)-nephrotic rats show high plasma renin, low plasma angiotensinogen (Angt), and increased urinary excretion of renin and Angt. In this work, we studied the effect of captopril on urinary excretion of total protein, renin, and Angt for 25 days after PAN injection. Captopril had no effect on total protein urinary excretion; however, captopril did enhance the urinary excretion of renin and did decrease the urinary excretion of Angt. This seems to be due to the fact that captopril magnifies the increase in renin and the decrease in Angt in the plasma of PAN-nephrotic rats.

ISSN:0886-022X    

DOI:10.3109/08860229209039125

出版商:Taylor&Francis    

年代:1992

数据来源: Taylor

摘要:

The records of 110 patients with acute renal failure (ARF) admitted to the Department of Medicine of the Philippine General Hospital during a 5-year period (1983-1988) were reviewed. The objectives were to evaluate the clinical profile of ARF patients and to determine what factors influenced mortality. Infection significantly influenced the causation and prognosis of ARF. Fifteen patients died, for an overall mortality rate of14%. Forty-six clinical variables were analyzed in order to identify factors correlated with mortality. Four variables significantly increased the risk of death from ARF: older age, hyperkalemia, oliguria, and presence of sepsis on admission. These characteristics define a subset of patients for whom more aggressive treatment of ARF is warranted.

ISSN:0886-022X    

DOI:10.3109/08860229209039126

出版商:Taylor&Francis    

年代:1992

数据来源: Taylor

摘要:

Glomerular function and renal tubular function assessed by measurements of creatinine clearance rates (CCR), lithium clearance rates (CLi, and N-acetyl-β-D-glucosaminidase (NAG) enzymuria were measured immediately prior to and within 24 h of operation (average operative time 150 min) in 16 patients undergoing a moderate surgical stress. Although serum creatinine concentrations and CCRwere similar pre- and postsurgery at 105±21 and 108±21µmol/L and 108±67 and 110±59 mL/min/100 kg body weight (mean±SD), respectively, both CLiand NAG were significantly increased following the surgical insult. CLiwas increased from 19.7±6.1 to 31.7±16.7mL/min/100kg (p<0.07) and NAG from 71±58 to 164±10 U/mmol urinary creatinine (p<0.001). In addition, the absolute distal tubular reabsorption of sodium and water increased from 18.3±5.9 and 15.8±9.7 to30.6±16.4 and 27.6±12.2 mL/min/100 kg body weight (both p<0.05), respectively. These results indicate early postoperative renal tubular dysfunction following a moderate surgical stress, undetected by conventional screening.

ISSN:0886-022X    

DOI:10.3109/08860229209039127

出版商:Taylor&Francis    

年代:1992

数据来源: Taylor

摘要:

Renal functional reserve (RFR) was investigated in a group of renal transplant recipients taking cyclosporin A (CyA) immunosuppressive therapy. Nine patients received a 93 g oral protein load containing 5983 mg of glycine. GFR and ERPF were measured using isotope infusions of51Cr EDTA and125I OIH, respectively, before and for 3 h after the meal. Patients studied demonstrated a wide range of baseline GFRs (20.9-89.5 mL/min, mean 50.09 mL/min). However, few patients demonstrated an individual RFR, regardless of original level of function. Overall, no significant change in either GFR or ERPF was demonstrated after the protein stimulus. CyA is known to alter intrarenal prostanoid synthesis in favor of vasoconstriction and RFR is thought to be mediated by prostanoids. Therefore a mechanism for the absence of RFR in patients receiving CyA therapy is suggested.

ISSN:0886-022X    

DOI:10.3109/08860229209039128

出版商:Taylor&Francis    

年代:1992

数据来源: Taylor

摘要:

Continuous venovenous hemodiafiltration (CVVHD) has been increasingly utilized for renal replacement therapy in the critically ill. We report details of a prospective study of CVVHD in 12 critically inpatients (7 males, 5 females; mean age 60 years, range 30- 72 years; Apache II score mean 27.4, range 21-35) with oligoanuric acute renal failure supported on CVVHD. Vascular access was obtained via double lumen subclavian or femoral cannulae. The mean pretreatment urea was 35.9 mM/L and the mean pretreatment creatinine was 559µM/L. After 24 h of of treatment on CVVHD these fell to a urea mean of 20.3 mM/L and a creatinine mean of 298µM/L and remained stable at these values for the duration of CVVHD. The mean net ultra-filtrate volume was 551 mL/h, with a urea clearance mean of 26.6 mL/min and a creatinine clearance mean of 23.7 mL/min. There were no complications related to use of the blood pump module or extracorporeal circuit. Excellent hemodynamic stability, control of fluid and electrolyte balance, and azotaemia control were maintained while on CVVHD. Technique survival was 100%. Patient survival was 42%. We conclude that CVVHD is a safe, effective, and durable therapy for the treatment of acute renal failure in the critically ill and that it offers outstanding metabolic control and cardiovascular stability.

ISSN:0886-022X    

DOI:10.3109/08860229209039129

出版商:Taylor&Francis    

年代:1992

数据来源: Taylor

摘要:

Although suprofen has been associated with the development of acute renal failure in greater than 100 subjects, the mechanism of damage remains unclear. The direct nephrotoxic effects of a single dose of 15 mg of suprofen were compared in the recirculating isolated rat kidney perfused with cell-free buffer with or without the addition of 5 mg/dL of uric acid. There were no significant differences in renal sodium excretion, oxygen consumption, or urinary flow rates in kidneys perfused with suprofen compared with the drug-free control groups. In contrast, a significant decline in glomerular filtration rate was found after the introduction of suprofen to the kidney perfused with uric acid; no changes were found with suprofen in the absence of uric acid. A significant decrease in the baseline excretion rate of uric acid was found in rats given suprofen, compared with drug-free controls. However, the fractional excretion of uric acid was unchanged between the groups over the experimental period. In summary, suprofen causes acute declines in renal function, most likely by directly altering the intrarenal distribution of uric acid.

ISSN:0886-022X    

DOI:10.3109/08860229209039130

出版商:Taylor&Francis    

年代:1992

数据来源: Taylor

摘要:

We report the characteristic CT scan findings of renal cortical necrosis in a patient of acute renal failure, which was confirmed on renal biopsy. CT scan is a useful, noninvasive investigative modality for an early diagnosis of renal cortical necrosis.

ISSN:0886-022X    

DOI:10.3109/08860229209039131

出版商:Taylor&Francis    

年代:1992

数据来源: Taylor

摘要:

We report a chronic hemodialyzed patient with bladder involvement of a secondary amyloidosis that presented as isolated hematuria evolving quickly to a massive hemorrhage and vesical rupture. We believe that this is the first report of bladder amyloidosis involvement in the course of hemodialysis. This knowledge may help in managing dialysis patients with hematuria.

ISSN:0886-022X    

DOI:10.3109/08860229209039132

出版商:Taylor&Francis    

年代:1992

数据来源: Taylor