摘要:

Inulin and para-aminohippuric acid clearances, determined by the conventional method of continuous intravenous infusion with blood and urine sample collections, are the gold standards for estimating glomerular filtration rate and renal plasma flow, respectively. Creatinine clearance provides a reasonably good estimate of glomerular filtration rate but is still subject to errors in accuracy and precision. However, novel methods employing cimetidine to block renal tubular creatinine secretion hold promise for improving the accuracy of estimates. More importantly, a large (and growing) number of studies have consistently demonstrated that estimating glomerular filtration rate by creatinine clearance calculated from the Cockcroft-Gault formula is better than measuring creatinine clearance with a 24-h urine collection. Until newer, more simple methods are developed, calculating creatinine clearance using fasting serum creatinine level, body weight, age and sex provides a reasonable and clinically useful bedside measure of glomerular filtration rate for the practising clinician.

ISSN:1062-4821    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

Several recently completed or ongoing large-scale clinical trials, including the Modification of Diet in Renal Disease Study, the Diabetes Control and Complications Trial, and the African-American Study of Kidney Disease and Hypertension, have all chosen the renal clearance of sodium125l-iothalamate to monitor renal disease progression. The need for accurate and precise renal testing at multiple clinical sites, with centralized renal sample processing, clearly exceeds the limited scope of most other glomerular filtration rate methods. Analysis of 3580 studies combined from the Modification of Diet in Renal Disease Study and Diabetes Control and Complications Trial demonstrates that trained clinical personnel can successfully perform the125l-iothalamate clearance glomerular filtration rate method in large-scale studies. Overall, intratest and intertest glomerular filtration rate coefficients of variation of approximately 10 and 6% are acceptable for such studies. Strict standardization of glomerular filtration rate protocol with respect to water loading, equilibration time after injection, and pre-study fasting is of crucial importance. Other confounding phenomena, including regression to the mean of progression slopes, must be considered before renal results of an intervention can be assessed. The125l-iothalamate clearance glomerular filtration rate method offers good accuracy and precision, reasonable clinical convenience, straightforward and efficient central laboratory analysis, and reasonable cost and safety for large-scale clinical trials.

ISSN:1062-4821    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

Aspirin renography, a new approach for the detection of renovascular hypertension, is described and compared with captopril scintigraphy. The behaviour of the new radiopharmaceutical99mTc-ethylenedicysteine is examined for the first time in patients with impaired renal function and compared with99mTc-mercaptoacetyltriglycine and with orthoiodohippurate. It is not yet possible to draw final conclusions about the advantages of aspirin renography and 99mTc-ethylenedicisteine over established methods and radiopharmaceuticals, respectively. In the diagnostic evaluation of renal transplants the degree of parenchymal retention is crucial. A newly described method for its quantitation is simpler and apparently more accurate than the excretion index frequently used.

ISSN:1062-4821    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

Radioactive tracers provide a unique means of determining individual renal function and are therefore to be preferred for obtaining accurate information on the functional status of each kidney. New applications of computed tomography and magnetic resonance imaging appear promising, but results from large studies are not available to confirm their potential role.

ISSN:1062-4821    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

A reliable method for the determination of renal function in pediatric patients is crucial for the planning of therapy and the administration of therapeutic agents in a variety of conditions. Inulin clearance, the gold standard for the measurement of glomerular filtration rate, is cumbersome and expensive; moreover, inulin is no longer available for clinical use in the USA. The articles reviewed herein reflect the search for simpler laboratory methods suitable for clinical use, new markers of glomerular and tubular function, and more accurate predictors of renal outcome in infants diagnosed prenatally to have urinary tract obstruction.

ISSN:1062-4821    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

As more scientific evidence accumulates concerning the relationship between ambulatory blood pressure and hypertensive organ disease, the technique of ambulatory blood pressure monitoring appears to be gaining a foothold in clinical practice and research. Over the past 2 years, an important follow-up study has revealed that ‘white coat’ hypertension has a low morbidity compared with sustained hypertension. However, other cross-sectional studies continue to fuel the debate regarding the definition and risks associated with white coat hypertension. The application of ambulatory blood pressure monitoring to clinical hypertension trials remains superior to that of office blood pressure measurements. As further data from other prospective interventional studies are published in the next few years, further definition of the utility of the technique will be possible.

ISSN:1062-4821    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

After an explosion of interest at the beginning of the 1990s in measuring quality of life in hypertensive patients, the past few years have seen relatively few studies in this area. This is partly because when new drugs were compared, in general, no clear advantage was observed for any particular drug or class of antihypertensive. More recently the emphasis on choosing antihypertensive treatments that have been shown to be effective in reducing cardiovascular morbidity and mortality, as well as constraints on resources, have focused attention on older drugs such as diuretics. Only a few trials have measured quality of life on a diuretic, but the largest and most powerful of these found no evidence that diuretics impair quality of life.

ISSN:1062-4821    

出版商:OVID    

年代:1995

数据来源: OVID