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Biomedical subjects

F C Luft

Publications and source records attributed to F C Luft.

At least 577 records · Page 32Linked to original sources
PubMed1978

Rapidly progressive glomerulonephritis in adults: clinical and histologic correlations.

The clinical and histological features of 43 patients with rapidly progressive glomerulonephritis were reviewed. All had extensive crescent formation in more than 50 per cent of glomeruli. Three distinct patterns of immunofluorescent staining were identified: linear, granular, and sparse staining. Electron microscopy was valuable in corroborating the results of immunofluorescence. The prognosis was poor, with no patient regaining normal renal function regardless of treatment. Significant differences were observed among patients categorized by immunofluorescent staining. Those with a linear pattern were younger and more commonly had hemoptysis. Patients with sparse immunofluorescent staining had better renal function at the time of presentation and a longer duration of illness.

Adolescent↗
PubMed1978

Failure of plasma exchange and immunosuppression to improve renal function in Goodpasture's syndrome.

A young woman with anti-glomerular basement membrane (GBM) antibody mediated rapidly progressive glomerulonephritis and pulmonary hemorrhage was treated with immunosuppression and intensive plasma exchange. She did not have end stage renal failure when therapy was initiated. Despite a dramatic reduction in circulating anti-GBM antibody, renal function progressively decreased. The role of plasma exchange in the therapy of anti-GBM antibody mediated disease remains unclear.

Adult↗
PubMed1977

Pharmacokinetics of cefaclor in normal subjects and patients with chronic renal failure.

We studied the pharmacokinetics of cefaclor, a new cephalosporin antibiotic, in normal subjects and subjects with chronic renal failure. Cefaclor was largely, but not entirely, eliminated by the kidneys. The cefaclor half-life in normal subjects was 40 to 60 min; in subjects with essentially no renal function, it increased to 3 h. In normal subjects, 50 to 70% of a 250-mg dose was excreted in the urine within 8 h. The linear relationship between the elimination constant and creatinine clearance allowed the construction of a useful dosage modification nomogram.

Animals↗
PubMed1977

Gentamicin gradient patterns and morphological changes in human kidneys.

The gentamicin gradient pattern was studied in ten autopsied patients who expired during gentamicin therapy. Although two of the patients had acute renal failure, none was thought to have gentamicin-related nephrotoxicity. Gentamicin concentrations in cortex significantly exceeded those in medulla or serum (p less than 0.05 and p less than 0.01, respectively). No correlation was found between the cortical concentrations and the total drug dose, the time interval between the last injection and death, or the plasma creatinine concentrations in this heterogeneous group of patients. In addition, two specimens were suitable for electron microscopy which displayed cytosegrosomes and myeloid bodies previously noted in experimental animals. We conclude that gentamicin forms a gradient pattern in human kidney similar to that described in experimental animals. Furthermore, it evokes similar morphological changes.

Adolescent↗
PubMed1977

Natriuretic response to saline infusion in normotensive and hypertensive man. The role of renin suppression in exaggerated natriuresis.

Previous studies have reported an exaggerated natriuresis in hypertensive man; however, a systematic appraisal of this response in various forms of hypertension has not been made. We measured fractional excretion of sodium (FENa) during a four hour intravenous infusion of 2 liters normal saline in 162 normal subjects and 120 hypertensives. Of these, 13 had primary aldosteronism (ALDO), 19 high renin (HRH), 30 low renin (LRH), and 57 normal renin (NRH) essential hypertension. FENa for normals (1.42%), NRH (1.57%), and HRH (1.46%) was similar. That for LRH (2.56%) and ALDO (4.18%) was elevated compared to the other three subgroups (P less than 0.001). Although the four hour FENa during saline infusion was associated with mean atrterial blood pressure (MABP) within the entire hypertensive population (r = 0.51), when the subgroups of the hypertensive patients were considered separately no association between FENa and MABP was identified. Moreover, the MABP of subjects with HRH was greater (P less than 0.05) than in those with NRH, although the FENa of the two subgroups was similar. Patients with ALDO and LRH have a greater natriuretic response to a salt load than do other subgroups of essential hypertension or normal subjects. The exaggerated natriuresis appears to be a feature of hypertension with renin suppression. The degree of exaggerated natriuresis in not solely a function of an elevated mean arterial blood pressure.

Adolescent↗
PubMed1977

The effect of concomitant mercuric chloride and gentamicin on kidney function and structure in the rat.

In order to define the possible effects of gentamicin on the course of experimental acute renal failure, the interaction between gentamicin and mercuric chloride was studied in rats. Acute renal failure was induced with 1 mg. of HgCl2 per kilogram intravenously. When given alone, HgCl2 produced a uniform, reproducible, nonoliguric, acute renal failure with a low mortality rate. Animals receiving gentamicin over the course of HgCl2-induced acute renal failure, in doses sufficient to produce a 1 hour postinjection serum concentration of 10 mug/ml., recovered glomerular filtration in a fashion similar to animals receiving only HgCl2(p greater than 0.05). Animals that recovered from HgCl2-induced acute renal failure were given 10 mg./Kg. of gentamicin every 4 hours for 15 days and developed proteinuria and decline in urine osmolality to the same degree as animals given gentamicin alone, but failed to develop azotemia. Nevertheless, morphological changes associated with gentamicin nephrotoxicity were found which were similar in severity to those seen with gentamicin alone. Animals pretreated with 10 mg./Kg. of gentamicin every 4 hours for 7 days were then given HgCl2. Acute renal failure in these animals was more severe than in animals receiving HgCl2 alone, as manifest by a greater degree of azotemia and death (p less than 0.05). The data indicate that in the rat the concomitant administration of gentamicin did not interfere with recovery from HgCl2-induced renal failure. Rats recovering from HgCl2-induced acute renal failure were resistant to a depression in glomerular filtration when given gentamicin. The prior administration of gentamicin enhanced the nephrotoxicity of HgCl2.

Acute Kidney Injury↗
PubMed1977

Factors affecting prognosis in acute renal failure following cardiac operations.

Twenty-five patients with acute renal failure following cardiac operations using cardiopulmonary bypass were analyzed retrospectively to identify predictors of survival or mortality. Age and the number of postoperative medical complications served as predictors of mortality, p less than 0.05. A low survival rate occurred if the patient was in the seventh decade of life. Nonsurvivors had a higher number of postoperative medical complications. However, only cardiac failure and bacteremia occurred in a significantly greater proportion of those patients who died, p less than 0.05. The presence of non-oliguric renal failure was associated with a 100 per cent survival rate, p less than 0.05. The mortality of these 25 patients was 28 per cent, which is lower than that generally reported. Although an extremely serious postoperative complication, acute renal failure following cardiac operations does not imply a hopeless prognosis. A vigorous therapeutic effort is warranted.

Acute Kidney Injury↗
PubMed1977

Differences in response to sodium administration in normotensive white and black subjects.

In order to examine possible differences in PRA, PA, and renal electrolyte excretion in normotensive black and white subjects, we studied 68 age-matched subjects: 19 white men, 19 black men, 15 white women, and 15 black women. PRA was measured before and after the infusion of 2 L of normal saline to evaluate suppression of the renin-aldosterone system. The excretion of sodium, potassium, and creatinine in response to the salt load was monitored for 24 hr. PRA and PA measurements were repeated after 2 hr of ambulation on the morning following salt loading. Dietary sodium was then restricted and oral furosemide (120 mg) was administered in order to assess PRA and PA responsiveness to sodium and volume depletion. White and black subjects had similar PRA and PA responses to normal saline and furosemide administration. Over a 24 hr period, black subjects excreted significantly less sodium and potassium following the salt load than did white subjects. The PRA values of black subjects 24 hr following the salt load were significantly suppressed as well. These observations suggest that there may be racial differences in renal sodium excretion reflected by decreased urinary sodium excretion and a relative suppression of PRA following a salt load in black persons.

Adult↗
PubMed1976

Intussusception in chronic renal failure.

Spontaneous intussusception in adults is rare. Recently, we managed two patients with chronic uremia in whom intussusception developed. Histologic examination of the resected segments showed intestinal intramural hemorrhage. We postulate that the coagulopathy associated with uremia may allow for intestinal intramural hemorrhage, thus forming a nidus from which intussusception may be initiated.

Adult↗
PubMed1976

Emphysematous pyelonephritis.

Emphysematous pyelonephritis is a rare complication of urinary tract infection and generally occurs in patients with diabetes mellitus or urinary tract obstruction. We recently treated an 81-year-old diabetic woman with Klebsiella pneumoniae urinary tract infection and septicemia whose abdominal roentgenogram demonstrated a striking left pneumonephrogram as well as intraureteral and perirenal gas. The patient died despite intensive therapeutic efforts. Unfortunately, the prognosis for this severe necrotizing infection process remains unfavorable.

Aged↗
PubMed1976

Comparative nephrotoxicities of netilmicin and gentamicin in rats.

The relative nephrotoxicities of netilmicin (Sch 20569) and gentamicin were compared in rats at doses of 30, 60, 90, and 120 mg/kg per day for 15 days. Both drugs caused proteinuria and a decrease in urine osmolality; however, netilmicin produced significantly less changes at all doses than gentamicin. Whereas gentamicin resulted in a decline in creatinine clearance at all doses, netilmicin failed to cause a decline in creatinine clearance. Renal-cortical concentrations of antibiotic at sacrifice were similar in animals receiving either drug. Light-microscopic changes were less severe with netilmicin than gentamicin. Cytosegresomes with myeloid bodies were identified electron microscopically in the kidneys of animals receiving either netilmicin or gentamicin at all doses. Electron-microscopic manifestations were similar. The data indicate that in the rat, netilmicin is distinctly less nephrotoxic than gentamicin.

Animals↗
PubMed1976

Nephrotoxicity of cephalosporin-gentamicin combinations in rats.

TO STUDY THE POSSIBILITY THAT CEPHALOSPORINS AUGMENT THE NEPHROTOXICITY OF GENTAMICIN, GROUPS OF RATS WERE GIVEN FOUR HOURLY SUBCUTANEOUS DOSES OF: gentamicin (5 mg/kg), gentamicin plus cephalothin (100 mg/kg), gentamicin plus cefazolin (20 mg/kg), gentamicin plus cefazolin (50 mg/kg), gentamicin plus cephaloridine (50 mg/kg), or saline diluent for 15 days. Periodic measurements were made of urine volume, urine osmolality, urine protein excretion and lysosomal enzymuria, as well as blood urea nitrogen, creatinine clearance, and drug concentrations in renal cortex and medulla. Tissue was examined by light and electron microscopy. Enzymuria and proteinuria increased early in the course of all treatment groups, whereas urine osmolality declined. No distinct patterns of these variables were discernable among the groups. Gentamicin alone, gentamicin plus cephalothin, and gentamicin plus cefazolin (20 mg/kg) caused the same significant fall in glomerular filtrate rate from control values by day 15 (P < 0.05). Gentamicin plus cefazolin (50 mg/kg) and gentamicin plus cephaloridine failed to cause a decline in glomerular filtration rate compared with controls (P > 0.05). Gentamicin concentrations in renal cortex were 5 to 10 times higher than those in medulla in all groups. Cephaloridine and cefazolin (50 mg/kg) also displayed a gradient pattern in renal cortex, whereas cephalothin and cefazolin (20 mg/kg) did not. Cytosegrosomes with myeloid figures were characteristic ultra-structural changes seen in all groups; however, they tended to be smaller with less numerous myeloid bodies in the groups receiving gentamicin plus cephalothin, cefazolin (50 mg/kg), or cephaloridine. Cephalosporins did not augment gentamicin toxicity. High doses of cefazolin and cephaloridine protected kidneys from gentamicin nephrotoxicity. The protection may involve intracellular drug interaction within the renal cortex.

Animals↗
PubMed1975

Thrombosis of the renal veins and vena cava. Occurrence in morbid obesity.

Renal vein thrombosis caused the nephrotic syndrome in a patient with morbid obesity. Pulmonary embolism occurred initially, but not after anticoagulants were administered. Surviving for three years, the patient died of profound uremia and hyperosmolar coma. At autopsy, membranous glomerular changes were found. Conclusive exclusion of renal vein thrombosis in the morbidly obese patient with nephrotic syndrome appears advisable.

Autopsy↗
PubMed1975

Recurrent acute renal failure with idiopathic paroxysmal myoglobinuria.

A second episode of myoglobinuric renal failure requiring dialysis developed in a muscular 30-year-old man. His first episode, which was not exercise-related, had occurred in childhood and was accompanied by chills, fever, and leukocytosis, whereas the second followed unaccustomed exertion 15 years later. Despite two occurrences of severe renal failure and intermittent episodes of myoglobinuria, renal function is presently normal. Idiopathic paroxysmal myoglobinuria may produce recurrent life-threatening acute renal failure; however, the prognosis for recovery, as evidenced by this case, appears favorable.

Acute Kidney Injury↗