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Biomedical subjects

A Aperia

Publications and source records attributed to A Aperia.

At least 199 records · Page 11Linked to original sources
PubMed1983

Renal function and biopsy changes during the course of Henoch-Schönlein glomerulonephritis.

Renal function studies were performed in 18 subjects in different stages of Henoch-Schönlein glomerulonephritis (HS GN). Nine children were serially investigated, and nine adolescents or young adults, who were considered to have clinically recovered, were investigated only once, 10.5-14 years after the onset. Inulin and PAH clearance, as well as sodium excretion, were determined during hydropenia (HP) and 3% volume expansion (VE) with isotonic saline. In most patients in the former group a renal biopsy was performed during the first investigation and again one year later. The early disturbances in renal function resembled those we have found in other types of GN. The GFR was normal during HP or after VE in most cases one year after the onset. The natriuretic response to VE was decreased in most patients initially, and this was found to persist in half of the patients 2-3 years after the onset. Pathological urinalyses then indicated disturbances in the renal handling of sodium. A reduced capacity to excrete sodium, however, did not seem to be of prognostic significance since all patients, except one who developed renal insufficiency and hypertension, had normal urinalyses and blood pressure six years after the onset. This study provides no evidence that subjects with previous HS GN will later develop impaired renal function or be predisposed to hypertension.

Biopsy↗
PubMed1983

Development of glomerular filtration rate and excretion of beta 2-microglobulin in neonates during gentamicin treatment.

Ten infants of different gestational ages (GA) and postnatal ages (PNA), treated with gentamicin, were compared with 10 control patients of similar GA and PNA to evaluate the possible nephrotoxic effects of this drug. Changes in the glomerular filtration rate (GFR) and the fractional excretion of beta 2-microglobulin in urine (FE beta) were used as indicators of renal dysfunction. In the control infants there was a postnatal increase in the GFR that was higher in full-term than in preterm infants. The FE beta decreased logarithmically as a function of both the GA and the PNA. The GFR was statistically lower in 5/10 and 6/10 of the patients on the first and the last days of gentamicin treatment (GT) respectively. Three weeks after GT, 8/10 had a normal GFR. The FE beta was statistically higher in 4/10 of the patients on their first day of GT and 7/10 on their last day of GT. Three weeks after GT, 9/10 of the patients had a normal FE beta for their postnatal and gestational ages. It is concluded that GT influences filtration and proximal reabsorption in GT infants by decreasing the GFR and increasing the FE beta. However, the observed renal dysfunction seemed to be reversible.

Beta-Globulins↗
PubMed1983

Increased fractional excretion of phosphate and beta 2-microglobulin in unilateral renal disease.

UNLABELLED: Following progressive nephron loss tubular reabsorption in the remaining nephrons will fall to preserve solute and electrolyte excretion. We have examined the fractional excretion (FE) of phosphate, sodium, beta 2-microglobulin (beta 2M) and tubular glucose reabsorption (T glucose) in children with unilateral renal disease to find 1) the threshold for this response and 2) whether intrinsic renal mechanisms can elicit this response. Separate renal function studies were performed using unilateral ureteral compression. Total glomerular filtration rate (GFR) was 93.7 +/- 2.99 ml/1.73(m2)-1 X min-1, and 110.25 +/- 5.40 in control children. GFR in the scarred kidney (SK) was 22.4 +/- 2.46 and in the contralateral kidney (CIK) 67.2 +/- 4.60 ml X 1.73 (m2)-1 X min-1. The kidney area was reduced in proportion to GFR in SK. FE phosphate and beta 2M were significantly higher in SK than in CIK (sign test), but absolute values for FE phosphate and beta 2M were not higher in SK than in control kidneys. FE sodium and T glucose were the same in SK and CIK. CONCLUSION: Following moderate unilateral reduction of GFR selective depression of tubular reabsorption can occur without extrarenal impulses.

Adolescent↗
PubMed1983

Effect of metabolic control and duration on exercise-induced albuminuria in diabetic teen-agers.

Nineteen type I diabetic teen-agers without clinical signs of nephropathy with a duration of diabetes varying from 3 to 16.8 years were examined by a standardized exercise test for analysis of urinary excretion of albumin and beta 2-microglobulin. The patients were studied both in poor and improved (but not perfect), metabolic control as defined by HbA1c and blood glucose profiles, and the values were compared to those of 14 age-matched healthy controls. The controls showed no increase in albumin excretion rate during exercise as was found in diabetic patients. The albumin excretion rate during exercise was significantly correlated (p less than 0.05) to systolic blood pressure in the diabetic patients. Blood pressure in the diabetic patients was, however, similar to that of controls both at rest and during exercise. Urinary beta 2-microglobulin did not change during exercise. The urinary albumin excretion during exercise decreased significantly with improved metabolic control in diabetic patients, but the albumin excretion rate was not correlated with either blood or urinary glucose or diuresis during the exercise test. When metabolic control was improved there was a significant correlation between the increase in albumin excretion rate during exercise and the duration of diabetes, indicating that part of the exercise-induced albumin excretion might reflect irreversible morphological changes in the diabetic kidney. This test might therefore have a predictive value for diabetic nephropathy if performed during strict metabolic control.

Adolescent↗
PubMed1983

Renal function in relation to metabolic control in children with diabetes of different duration.

To evaluate the interpretation of different kidney function tests in diabetic children and teenagers we have studied 47 children with a duration of diabetes up to 5 years, 61 children with a duration of 5.1-10 years and 49 children with a duration of greater than 10 years. Glomerular filtration rate (GFR) measured as inulin clearance or creatinine clearance, clearance PAH (CPAH), filtration fraction (FF), 24-hour urinary excretion of beta 2-microglobulin and albumin were examined and correlated with short- and longterm indices of metabolic control. In all groups of duration GFR as measured by inulin clearance was increased compared with reference values from age matched controls. In patients who had had diabetes for 0-5 years a significant positive correlation was found between inulin clearance and blood glucose during the examination. Inulin clearance was also correlated to HBA1c as well as to 24-hour urinary glucose (mean of 4-6 samples during two years). No such correlation was found in the group who had had diabetes for 5-10 years but in patients with a duration of diabetes greater than 10 years a significant inverse relation was found between GFR and HbA1c. The 24-hour urinary excretion of albumin was significantly higher in all groups of diabetics compared with controls. The urinary excretion of beta 2-microglobulin was similar in diabetics and controls. In the total material no significant correlation could be found between inulin clearance and creatinine clearance.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1983

Structural and functional development of the nephron.

The present review deals with structural and functional relationships during the development of the nephron. Ultrastructural morphometric technique has been used to obtain quantitative data on structural observations in order to make correlations between structure and function possible. The area of the glomerular basement membrane was found to increase by a factor 1.7 when relating the change in glomerular basement surface area to kidney weight. Furthermore it is suggested that a permeability change of the glomerular basement membrane occurs during development and that this change probably is the result of an increased area of endothelial pores and epithelial slits. The increased capacity of different nephron segments to transport Na and fluid is directly correlated to the increase in the area of the basal and lateral cell membranes as well as the amount of Na-K-ATPase. This suggests a significant contribution of these factors to the maturation of solute and fluid transport through the tubular wall.

Absorption↗
PubMed1983

Postnatal control of water and electrolyte homeostasis in pre-term and full-term infants.

A review is given of the progress which has been made during the last decade within the field of renal control of water and sodium homeostasis in newborn infants of varying gestational age. Both preterm and full-term infants have a low capacity for rapid excretion of a salt load. The natriuretic response improves gradually up to the age of 15 months. The capacity to excrete a load of sodium bicarbonate is higher than to excrete a load of sodium chloride. Under basal conditions preterm infants of a gestational age below 35 weeks have a higher renal sodium excretion than full-term infants. They also appear to be unable to retain sodium when in negative balance. The capacity to concentrate the urine is low in newborn infants, the maximal osmolality being only slightly above that of plasma. The concentrating capacity increases relatively fast during the first 4-6 postnatal weeks in full-term as well as in pre-term infants but does not reach the adult level until the second year. Water loaded newborn infants are able to excrete a urine with a osmolality as low as 30-50 mOsm per kg. In full-term infants free water clearance per unit filtered water is higher than in adults. Water-loaded pre-term infants with a gestational age of more than 30 weeks also have a supernormal diluting capacity.

Aldosterone↗
PubMed1983

Glomerular tubular balance in preterm and fullterm infants.

The development of glomerular and tubular function was studied in preterm and fullterm infants of varying gestational and postnatal age. The results indicate that glomerular functional development precedes tubular functional development until the 34th postmenstrual week. After the 34th week the tubular transport capacity seems to be more vulnerable than the glomerular filtration rate in states of disease. The release of a postulated renal vasoconstriction could account for the rapid changes in renal function after birth. The purpose of such a vasoconstriction could be to protect the tubules from an overload.

Absorption↗
PubMed1983

Effect of betamethasone on Na-K-ATPase activity and basal and lateral cell membranes in proximal tubular cells during early development.

The mechanism by which betamethasone induces Na-K-ATPase activity in developing tissue was studied in homogenates of proximal tubular cells from 10-day-old rats. A significant increase in Na-K-ATPase activity occurred after 5 micrograms . 100 g-1 . 12 h-1 X 2 beta-methasone and a maximal increase after 15-60 micrograms . 100 g-1 . 12 h-1 X 2. Following a single dose of 60 micrograms . 100 g-1 betamethasone Na-K-ATPase activity increased significantly after 16 h and maximally after 24-30 h. The 16-h time lag suggests that betamethasone does not act only directly on Na-K-ATPase synthesis. Betamethasone 60 micrograms . 100 g-1 increases Na-K-ATPase activity significantly in kidneys in which glomerular filtration rate is reduced by ureteral ligation, but the increase is significantly less pronounced than in kidneys with intact ureters, suggesting that the induction is not mediated only by alterations in sodium supply. Twenty-four hours after 10-60 micrograms . 100 g-1 betamethasone there was no significant increase in glucose-6-phosphatase and Mg-ATPase activity in 10-day-old rats or in Na-K-ATPase activity in 40-day-old rats. The basal and lateral cell membranes of the proximal tubular cells were not significantly increased 24 h after 60 micrograms . 100 g-1 betamethasone. Accordingly, structural development is not a prerequisite for enzymatic differentiation.

Aging↗
PubMed1983

Influence of diuresis on the degree of vesicoureteral reflux. An experimental investigation in rats.

The influence of bladder filling volume (BV), bladder pressure (BP) and diuresis (V) on the occurrence of vesicoureteral reflux (VUR) in Sprague-Dawley rats, where spontaneous VUR is common, has been investigated. The BV and BP at which VUR occurred during constant low diuresis (group I), high inconstant diuresis (group II) and moderately high, constant diuresis (group III), was measured. The abdomen was opened for visual observation of the VUR. The bladder was catheterized with a double-lumen metal catheter for infusion of a Lissamine green saline solution and to enable recording of BP. VUR occurred at significantly lower BV in group II than in group I and at significantly lower BV and BP in group I than in group III.

Animals↗
PubMed1982

Urinary excretion of prostaglandin F2 alpha and 6-keto-prostaglandin F1 alpha during volume expansion in patients with glomerulonephritis.

Thirteen patients with active IgA glomerulonephritis (IgA GN), ten patients with a history of Henoch-Schönlein glomerulonephritis (HS GN) and nine healthy controls were studied during hydropenia (HP) and 3% volume expansion (VE) with isotonic saline. Clearance of inulin and para-aminohippurate, urinary excretion of Na, immunoreactive prostaglandin F2 alpha (PGF2 alpha) and 6-keto-prostaglandin F1 alpha (6-keto-PGF1 alpha) were determined. The patients with a history of HS GN had normal blood pressure and renal function. As in the controls, the urinary excretion of PGF 2 alpha decreased and the excretion of 6-keto-PGF1 alpha increased during VE. In the patients with IgA GN the glomerular filtration rate (GFR) was normal, markedly reduced and supernormal. Five patients had hypertension and an increased NA excretion in relation to the GFR during VE. As a group, the patients with IgA GN increased their urinary excretion of 6-keto-PGF1 alpha during VE, while the excretion of PGF2 alpha did not change. In relation to the GFR, the urinary excretion of PGF2 alpha and 6-keto-PGF1 alpha was markedly increased in two patients with low GFR, which implies that these substances play a role in advanced renal disease. VE had little effect on PG excretion in these patients. In the hypertensive patients the urinary excretion of PGF2 alpha and 6-keto-PGF1 alpha was the same as in those with normal blood pressure. PGs are therefore not likely to mediate the increased natriuretic response to VE in hypertension.

6-Ketoprostaglandin F1 alpha↗
PubMed1982

Course of renal function in IgA glomerulonephritis in children and adolescents.

The pathophysiology of IgA GN was investigated in different stages of the disease. Seventeen patients who were between 3.5 and 16.5 years of age at the onset were included in the study. Clearance studies were performed repeatedly in 6 patients (in 5 of them over a period extending from the onset to 5-9.5 years) and only once in 9 patients (10-23 years after the onset). Two patients (one with uremia) were only evaluated clinically. CIn, CPAH and UNaV were studied during hydropenia (HP) and 3% isotonic saline volume expansion (VE). Shortly after the onset CIn, CPAH and UNaV were depressed. Renal function was essentially normal and 1 and 2 years after the onset in spite of signs of active disease. A supernormal GFR was found in 7 patients after they had had the condition between 5 and 17 years. After a duration of IgA GN for greater than 9 years 3 of 12 patients had developed hypertension and uremia and 2 had hypertension or labile BP. Three of 10 patients had a normal GFR and BP, but had increased natriuresis during VE. Only 2 of 10 patients were normotensive and had normal renal function. Disturbances in the renal function are thus frequent in all stages of IgA GN and the changes seem to be related to the duration of the disease. Exaggerated natriuresis may indicate progressive disease.

Adolescent↗
PubMed1982

Implications of limitation of renal function for the nutrition of low birthweight infants.

Renal function is immature in low-birth-weight infants. The glomerular filtration rate is low during the entire first month of life. It is 20-50% of that observed in older children and adults. This limits the excretory capacity of the kidney and might set an upper limit for the protein intake. The capacity to reabsorb bicarbonate is not fully developed. This predisposes the low-birth-weight infant to metabolic acidosis. The capacities to excrete sodium when in positive sodium balance and to retain sodium when in negative sodium balance are limited. If the daily sodium balance is not well monitored, conditions of negative sodium balance with hyponatremia as well as of positive sodium balance with hypernatremia might occur.

Acid-Base Equilibrium↗
PubMed1982

The effect of prostaglandin inhibition on renal function in the developing anesthetized lamb.

The importance of prostaglandin (PG) compounds for renal function in the developing kidney was studied by comparing renal blood flow (RBF), glomerular filtration rate (GFR) and fractional sodium (Na) excretion in control lambs and lambs treated with a PG synthesis inhibitor, indomethacin. The lambs were 1-2 and 4-6 weeks old and they were studied either during hydropenia (HP) or volume expansion (VE). Indomethacin significantly decreased Na excretion in both groups of hydropenic lambs. Indomethacin also completely blunted the natriuretic response to VE in the older lambs but had no effect on Na excretion in the volume expanded younger lambs. It is concluded that partial lack of PG inhibiting action on tubular Na transport will contribute to the poor natriuretic response to VE in neonatal lambs. Since PG will act locally rather than being blood-borne messengers, The divergent PG action in younger and older lambs might be explained by local differences in maturation of PG metabolism as well as by local differences in the maturation of PG sensitivity.

Age Factors↗
PubMed1982

Renal function in dogs with chronic moderate unilateral ureteral obstruction.

Partial obstruction of the left ureter was created in seven dogs. Renal function was studied 3 weeks later. Total renal blood flow (RBF) and intrarenal blood flow distribution were studied using the microsphere technique. Glomerular filtration rate (GFR), effective renal plasma flow (CPAH) and the excretion of sodium and osmolar substances were determined using the clearance technique. RBF, GFR and CPAH in the hydronephrotic kidney were reduced to approximately 30% of the same parameters in the contralateral kidney. Urinary sodium excretion was consistently lower in the hydronephrotic than in the contralateral kidney. Volume expansion with isotonic saline solution revealed that this reduction of sodium excretion from the hydronephrotic kidney was out of proportion to the extent of GFR reduction. The contralateral unobstructed kidney did not compensate for this salt retention by increasing its sodium excretion.

Animals↗