Pharmacokinetics of cefazolin patients with normal and impaired renal function.
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Biomedical subjects
Publications and source records attributed to E K Brodwall.
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In the present study, renal A-V oxygen difference and renal blood flow were measured in 18 patients with mitral valvular disease. The renal sodium reabsorption and oxygen consumption have also been measured. The renal A-V oxygen difference was small and remained within the normal range despite large reductions in renal blood flow. Only when flow fell to between 400 and 500 ml. per minute there was a rise in A-V oxygen difference. The renal oxygen consumption was in general reduced compared with normal subjects, but tended to increase in those patients who also had the greatest values for A-V oxygen difference. The renal oxygen consumption was found to vary independently of the sodium reabsorption. Our results indicate a shift to a more aerobic renal metabolism in advanced heart failure when renal blood flow is drastically reduced. It is possible that the variations in oxygen demand may reflect changes in substrate requirements for transport of sodium in different circulatory situations. Redistribution of flow within the kidney at low renal blood flow as well as the possibility of passive transport of sodium in the proximal tubules might also account for the changing relationship between A-V difference and renal blood flow.
A 25-year-old man presented with severe hypertension associated with hypokalemia, elevated plasma renin level and secondary hyperaldosteronism. Malignant phase hypertension and renal artery stenosis were ruled out, and a preoperative diagnosis of renin-secreting renal tumour was made on the basis of higher concentrations of renin in the left than in the right renal venous plasma in spite of normal findings on selective renal arteriography. By removal of the affected kidney the tumour was found and it had a very high content of renin. Following the operation the plasma renin level, serum aldosterone concentration and BP became normal. We present a histopathological description and an ultrastructural study of the tumour.
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