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PubMed2004

Filtration fraction and its implications for radionuclide renography using diethylenetriaminepentaacetic acid and mercaptoacetyltriglycine.

PURPOSE: Glomerular filtration rate (GFR) and effective renal plasma flow (ERPF) were determined in 92 patients to calculate filtration fraction (GFR/EFPR) and evaluate its change in renal diseases. This information was used as the rationale for a renogram protocol using DTPA (to estimate GFR) and MAG3 (to produce images and curves). METHODS: Individual kidney GFR and ERPF were determined by gamma camera techniques using Tc-99m DTPA and I-131 OIH. Two hundred sixty-one determinations were performed in 92 patients who in turn were grouped into 4 categories: normal, obstruction, renal vascular disease, and chronic insufficiency. RESULTS: Mean filtration fractions in normal patients and those with obstruction were similar (0.16 and 0.15, respectively), whereas they were lower in renal vascular disease (0.11) and chronic renal insufficiency (0.08). Low filtration fraction indicates disproportionate loss of GFR compared with ERPF and was the pattern observed with advancing renal disease in most patients. The exception was ATN or contrast nephropathy when filtration fraction was increased (0.22) as a result of disproportionate loss of ERPF compared with GFR. CONCLUSIONS: OIH is no longer available in the United States, and MAG3 is now used as the renal tubular agent in renography. Clearance of MAG3 does not directly measure ERPF, but this might not be a significant loss in clinical practice if GFR is measured during renography because it is more adversely affected by renal disease than ERPF (with the exception of ATN and contrast nephropathy). Accordingly, a renogram protocol is presented for the combined use of DTPA and MAG3 resulting in GFR estimation (from DTPA) while yielding superior renal images and renogram curves from MAG3.

Adolescent↗
PubMed1998

Scatter-glare estimation for digital radiographic systems: comparison of digital filtration and sampling techniques.

The scatter and veiling glare distribution in images acquired with a digital subtraction angiography imaging system was estimated using a digital filtration and a beam-stop technique. The digital filtration technique utilizes exposure parameters and image gray levels to estimate scatter-glare intensity based on previous phantom measurements. The beam-stop technique uses an array of lead discs in order to sample scatter-glare intensity for each patient. To test the ability of digital filtration and beam-stop techniques to estimate the scatter-glare intensity, they were applied to images of postmortem swine animal models at different projections and beam energies. The systematic and root-mean-square (rms) percentage errors of these estimates were obtained by comparison to directly measured scatter-glare images using a scanning lead strip technique. The average rms percentage error for the digital filtration and beam-stop techniques were 8.07% and 6.67%, respectively. The changes in scatter-glare intensity due to contrast injection during coronary arteriography and ventriculography were also measured using the beam-stop technique. The maximum changes in scatter-glare intensities during coronary arteriography and ventriculography were 19 and 88%, respectively. The results indicate that the digital filtration technique is more suited for applications such as coronary arteriography and ventriculography where the iodinated contrast material significantly changes the scatter-glare intensity.

Angiography, Digital Subtraction↗
PubMed1992

A comparison of the filtration properties of heat and moisture exchangers.

Heat and Moisture Exchangers are used increasingly as filters to prevent the contamination of breathing apparatus and to limit cross-infection. A series of laboratory tests has been developed to evaluate the microbial filtration and air flow resistance properties of these devices. The tests were designed to simulate the clinical situation and therefore evaluated devices in both dry and wet conditions. The devices tested (Engstrom Edith, Pall BB50T, Dar Hygrobac, Intersurgical Filtatherm and Intersurgical Filtaguard) were each representative of a particular type of construction. The simple hygroscopic device (Engstrom Edith) showed poor airborne and liquid-borne filtration efficiency, but its resistance to air flow remained low in all conditions. The composite devices (Dar Hygrobac, Intersurgical Filtatherm and Intersurgical Filtaguard), which all possessed relatively large pores, performed well in terms of dry airborne filtration efficiency, but showed substantial increases in air flow resistance and poor filtration efficiency in the presence of liquid. The pleated membrane filter (Pall BB50T), which possessed small pores, showed good airborne filtration efficiency and prevented the passage of liquid. The latter property enabled this device to prevent the passage of liquid-borne contamination and to maintain a low resistance to air flow in wet conditions. It would appear that in terms of contamination control and air flow resistance the pleated membrane filter provides a wider margin of safety than either the hygroscopic or composite devices.

Air↗
PubMed1996

A comparison of a new campylobacter selective medium (CAT) with membrane filtration for the isolation of thermophilic campylobacters including Campylobacter upsaliensis.

The newly developed CAT campylobacter selective medium employing the blood-free charcoal-based agar containing cefoperazone (8 mg l-1), amphotericin (10 mg l-1) and teicoplanin (4 mg l-1) was compared with the membrane filtration culture technique for isolation of Campylobacter spp. including Camp. upsaliensis. Nine hundred and fifty human, 275 dog and 65 cat faeces (in which modified CCDA medium was also compared) were tested. In addition, the recovery of Camp. upsaliensis from pure cultures and from spiked human faeces was examined after membrane filtration. A 50-fold reduction in recovery after filtration using the 0.65 micron filters and a 150-fold reduction using the 0.45 micron filters was found. Recovery of Camp. upsaliensis from spiked faeces was considerably improved using the CAT medium compared with filtration, especially with the lower concentration of organisms (approx. 10(4) cfu mL-1). Campylobacter upsaliensis was recovered from 91 specimens of animal faeces, with CCDA recovering 26 isolates (29%), CAT recovering 76 isolates (84%) and membrane filtration (0.65 microns) recovering 82 isolates (90%). CAT selective agar was found to be a suitable medium for the isolation of thermophilic campylobacters including Camp. upsaliensis from faecal samples.

Animals↗
PubMed1982

Removal of leukocytes from blood by fibre filtration. A comparison study on the performance of two commercially available filters.

Two different kinds of filters suitable for the almost complete removal of leukocytes from blood-cell concentrates were tested. The maximal retention of filter I was 1.9-3.4 x 10(9) leukocytes per filter, whereas filter II could retain 3.6 - 7.8 x 10(9) leukocytes per filter before the leukocyte concentration in the filtrate passed the level of 500 leukocytes/micrometer. The leukocytes, once absorbed by the fibre material, could be released by washing the filters I, whereas the leukocytes were retained by the material of the filters II. No detectable particles were released after the first 100 ml of filtrate during the washing procedure of either kind of filters. From more than 20% of the filters I, more than 500 pg/ml of endotoxin could be released during the prewashing, whereas none of the filters II was contaminated with endotoxin. The filter II released acetic acid which could be completely removed during the prewashing with 250 ml of saline solution. Operation according to the prescribed conditions of 25 filters of both kinds revealed that the residual leukocyte content in the filtrate was more than 0.25 x 10(9) leukocytes in 8 out of 25 of the filtrates when filters I were used, whereas with all filters II, this content remained lower than 0.1 x 10(9) leukocytes per filtrate. It was concluded that only filter II has sufficient capacity to guarantee the removal of 97% of all leukocytes and 90% of the thrombocytes present in 500 ml of fresh human blood.

Cell Separation↗
PubMed1989

In vitro and in vivo evaluation of platelet concentrates after cotton wool filtration.

Removal of leukocytes from platelet concentrates (PC) may decrease the incidence of alloimmunization to HLA antigens on white cells and prevent or delay refractoriness. Cotton wool filtration, which effectively removes leukocytes from PC with minimal platelet loss, may cause platelet or complement activation. In this study, the effect of cotton wool filtration (Imugard IG-500) on platelet activation, in vitro function, posttransfusion survival, and complement activation was investigated. Five paired autologous in vivo percent recovery and survival studies were performed with fresh (6-8h) PC or with 5-day-stored PC prepared from CPD-anticoagulated blood and stored in PL-732(TM) containers using standard methods. In the paired design, PC from the same donor were filtered on one occasion, and not filtered on another, prior to labeling with indium-III-oxine and reinfusion. Percent recovery and survival were then determined by the standardized method. Filtration had no statistically significant effect on percent recovery on PC stored for 6-8h or for 5 days. There was, however, a slight decrease in survival hours of the filtered PC which was statistically significant at 6-8h (203 +/- 14 vs. 179 +/- 18h; p less than 0.05) but not at 5 days (166 +/- 28 vs. 132 +/- 27h; p greater than 0.05). Samples taken before and after filtration of single units (fresh and 5-day) and pooled units (3-day) for measurement of release of granular content (beta-thromboglobulin), lysis (LDH), and in vitro viability - ATP, extent of shape change with ADP, and hypotonic shock response (3-day only)-demonstrated no effect of filtration on these parameters.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1994

Adsorption filtration of leukocyte-reduced single donor platelet units.

The effect of adsorption filtration of leukocyte-reduced single donor platelet (SDP) units collected on a CS-3000+ with a TNX chamber was compared to filtration of SDP units prepared via an isoradial chamber. The leukocyte enumeration technique employed a Nageotte chamber and had a nominal lower detection limit of 0.05 leukocytes/microliter (if no cells were seen, the concentration was recorded as 0.01 microliter). Although the prefiltration leukocyte content of the TNX units was unexpectedly low (2.4 +/- 2.8 x 10(4) per unit), filtration reduced the leukocyte content further to no greater than 1.7 +/- 0.07 x 10(3) (p < 0.05). (The full extent of the leukocyte removal could not be assessed as no leukocytes were seen in counting any of the 20 filtered TNX units). The 20 isoradial (control) SDP units achieved similar leukocyte depletion, with a postfiltration leukocyte content of 2.7 +/- 2.5 x 10(3) (p > 0.05, compared to filtered TNX units). Thus while significant leukocyte reduction occurred with adsorption filtration of both control and leukocyte-depleted SDP units, comparison of the relative degree of reduction awaits application of more sensitive leukocyte counting techniques. This study documented, however, that additional leukocyte reduction can be obtained by applying adsorption filtration to SDP units with an already low leukocyte content.

Adsorption↗
PubMedDate not supplied

Does increased glomerular filtration rate or disturbed tubular function early in the course of childhood type 1 diabetes predict the development of nephropathy?

To clarify whether glomerular hyperfiltration or disturbances in renal tubular function may be early markers of the later development of nephropathy a follow-up study was performed in 34 young Type 1 diabetic patients, who had originally been investigated 12 years previously. The initial median age was 14 (range 7-18) years and median diabetes duration 7 (2-14) years. At initial examination only one of the 34 diabetic patients exhibited increased urinary albumin excretion rate. The median glomerular filtration rate was increased (136 vs 107 ml min-1 1.73 m-2; p less than 0.0001) and median threshold concentration of phosphate per litre of glomerular filtrate was decreased (1.27 vs 1.76 mmol l-1; p less than 0.0001) in the diabetic group as compared to that of 28 healthy children. At follow-up 17 patients showed increased urinary albumin excretion rate and the median glomerular filtration rate in this group was significantly lower than that of 17 patients with normal urinary albumin excretion rate (108 vs 125 ml min-1 1.73 m-2; p less than 0.05). However, no relationships were found between the increased urinary albumin excretion (incipient and/or overt diabetic nephropathy) at follow-up to either the initial glomerular filtration rate (134 vs 137 ml min-1 1.73 m-2; p greater than 0.05) or to renal tubular function assessed from urinary excretion rate of beta 2-microglobulin (0.059 vs 0.069 microgram min-1; p greater than 0.05) and the renal threshold concentration of phosphate per litre of glomerular filtrate (1.29 vs 1.22 mmol l-1; p greater than 0.05).

Adolescent↗
PubMed1980

A comparison of the ability of two angiotensin II receptor blocking drugs, 1-Sar; 8-Ala angiotensin II and 1-Sar, 8-Ile angiotensin II, to modify the regulation of glomerular filtration rate in the cat.

1 Modest stimulation of the renal nerves in the anaesthetized unilaterally nephrectomized cat resulted in a 15% fall in renal blood flow, no change in glomerular filtration rate and significant falls in both the absolute and fractional rates of sodium excretion.2 The haemodynamic responses to nerve stimulation were not modified by angiotensin II blockade with 1-Sar, 8-Ala angiotensin II although the fall in absolute, but not fractional sodium excretion was significantly larger. In contrast, stimulation of renal nerves following administration of 1-Sar, 8-Ileangiotensin II caused a significant fall in glomerular filtration rate. The reductions in both absolute and fractional sodium were of the same magnitude as in the absence of drug.3 Both renal blood flow and glomerular filtration rate were autoregulated during the reduction of renal perfusion pressure and this was associated with reductions in both absolute and fractional sodium excretions.4 In the presence of 1-Sar, 8-Ala angiotensin II, the haemodynamic and sodium excretory responses to reductions in renal perfusion pressure were not significantly different from those recorded in the absence of drug. However, following administration of 1-Sar, 8-Ile angiotensin II, renal blood flow but not glomerular filtration rate, was autoregulated during reduction in renal perfusion pressure. The falls in absolute and fractional sodium excretions caused by this manoeuvre were of similar magnitude to those obtained in the absence of drug.5 The results obtained using the 1-Sar, 8-Ile angiotensin II are consistent with angiotensin II having an important intra-renal site of action to regulate glomerular filtration rate, possibly via an action at the efferent arteriole. Administration of 1-Sar, 8-Ala angiotensin II was without effect on the regulation of renal haemodynamics which it is suggested reflects a limitation in the use of this particular compound as an intrarenal angiotensin II antagonist.

1-Sarcosine-8-Isoleucine Angiotensin II↗
PubMed1996

A simple filtration method to remove plankton-associated Vibrio cholerae in raw water supplies in developing countries.

Plankton to which cells of Vibrio cholerae O1 and/or O139 were attached was introduced into 0.5% Instant Ocean microcosms maintained at 25 degrees C. The bulk of the plankton and associated particulates was removed with a filter constructed from either nylon net and one of several different types of sari material, the latter being very inexpensive and readily available in villages in Bangladesh, where V. cholerae is endemic. V. cholerae was enumerated before and after filtration to evaluate the efficiency of the filtration procedure. The results obtained indicate that 99% of V. cholerae, i.e., those cells attached to plankton, were removed from the water samples. Epidemic strains of V. cholerae O1 and O139 from various geographical sources, including Bangladesh, Brazil, India, and Mexico, were included in the experiments. Removal of vibrios from water by this simple filtration method was found to yield consistent results with all strains examined in this study. Thus, it is concluded that a simple filtration procedure involving the use of domestic sari material can reduce the number of cholera vibrios attached to plankton in raw water from ponds and rivers commonly used for drinking. Since untreated water from such sources serves as drinking water for millions of people living in developing countries (e.g., Bangladesh), filtration should prove effective at reducing the incidence and severity of outbreaks, especially in places that lack fuel wood for boiling water and/or municipal water treatment plants. The results of this study provide the basis for determining such reductions, which are to be carried out in the near future.

Animals↗
PubMed1998

Cross sectional longitudinal study of spot morning urine protein:creatinine ratio, 24 hour urine protein excretion rate, glomerular filtration rate, and end stage renal failure in chronic renal disease in patients without diabetes.

OBJECTIVE: To evaluate whether the protein:creatinine ratio in spot morning urine samples is a reliable indicator of 24 hour urinary protein excretion and predicts the rate of decline of glomerular filtration rate and progression to end stage renal failure in non-diabetic patients with chronic nephropathy. DESIGN: Cross sectional correlation between the ratio and urinary protein excretion rate. Univariate and multivariate analysis of baseline predictors, including the ratio and 24 hour urinary protein, of decline in glomerular filtration rate and end stage renal failure in the long term. SETTING: Research centre in Italy. SUBJECTS: 177 non-diabetic outpatients with chronic renal disease screened for participation in the ramipril efficacy in nephropathy study. MAIN OUTCOME MEASURES: Rate of decline in filtration rate evaluated by repeated measurements of unlabelled iohexol plasma clearance and rate of progression to renal failure. RESULTS: Protein:creatinine ratio was significantly correlated with absolute and log transformed 24 hour urinary protein values (P = 0.0001 and P < 0.0001, respectively.) Ratios also had high predictive value for rate of decline of the glomerular filtration rate (univariate P = 0.0003, multivariate P = 0.004) and end stage renal failure (P = 0.002 and P = 0.04). Baseline protein:creatinine ratios and rate of decline of the glomerular filtration rate were also significantly correlated (P < 0.0005). In the lowest third of the protein:creatinine ratio (< 1.7) there was 3% renal failure compared with 21.2% in the highest third (> 2.7) (P < 0.05). CONCLUSIONS: Protein:creatinine ratio in spot morning urine samples is a precise indicator of proteinuria and a reliable predictor of progression of disease in non-diabetic patients with chronic nephropathies and represents a simple and inexpensive procedure in establishing severity of renal disease and prognosis.

Circadian Rhythm↗
PubMed1971

Endogenous creatinine clearance as a clinical measure of glomerular filtration rate.

Endogenous creatinine clearance was assessed by inulin in 91 simultaneous studies in 41 patients and proved an accurate measurement of glomerular filtration rate. For filtration rates <20 ml/min the creatinine clearance may slightly overestimate the glomerular filtration rate. Successive determinations of filtration rate by either method may vary by 20% even though the methods agree with each other. Glomerular filtration rate itself is variable, and in its clinical usage this should be recognized.

Adolescent↗
PubMed1988

Estimation of glomerular filtration rate from the serum creatinine concentration.

In patients with renal failure the dose of renally excreted drugs should be reduced in proportion with the degree of impairment of glomerular filtration: in this situation it is appropriate to measure the glomerular filtration rate in order to determine accurately the correct dose. However, as 24 hour urine based creatinine clearance measurements are time consuming and inaccurate, the parameter most often used to estimate renal function in clinical practice is the serum creatinine concentration. An isolated serum creatinine concentration is unsatisfactory for this purpose as it depends on creatinine production, which is related to muscle mass, as well as on renal elimination of creatinine. A variety of formulae and nomograms have been devised to assist clinicians in predicting the glomerular filtration rate from a stable serum creatinine concentration and the patient's sex, age and weight (or height). Although some of these formulae have been available for over 15 years, the majority of doctors cannot estimate accurately the glomerular filtration rate from these parameters. It is proposed in this paper that biochemistry results computers should employ one of these formulae to calculate the glomerular filtration rate/70 kg, using the age and sex information provided on the request form, each time a serum creatinine concentration is reported. These formulae are invalid in several well defined clinical situations which could be briefly outlined on the report.

Creatinine↗
PubMed1989

Filtration coefficient in cat hindlimb using protein concentration changes.

The maximum value of capillary filtration coefficient (CFC) in maximally vasodilated cat skeletal muscle is disputed. It was hypothesized that the wide range of reported values was caused by the inability of gravimetric and volumetric measurements of tissue volume to separate transcapillary filtration from vascular volume changes. Consequently, we developed a method of measuring filtration rates from changes in venous protein concentration using Evan's blue-labeled albumin in the isolated hindlimb (pentobarbital sodium anesthesia). The filtration coefficient (PFFC) calculated from these filtration rates after a step in venous pressure should not be influenced by vascular volume changes. When the perfusate flow rate through the hindlimb was greater than 15 ml.min-1.100 g muscle-1, PFFC was 0.0085 +/- 0.0015 (SD, n = 8) ml.min-1.mmHg-1.100 g muscle-1. PFFC was observed to be unvarying from 1 to 12 min after the venous pressure elevation, in contrast to CFC values, which fall during the same period. It is argued that the difference between CFC and PFFC values is caused by vascular volume changes.

Algorithms↗
PubMed1976

Determinants of glomerular filtration rate in the dog.

Micropuncture techniques were used to evaluate the determinants of glomerular filtration in hydropenic dogs. Stop-flow and servo-null techniques were used to estimate the glomerular capillary and proximal tubule hydrostatic pressures. The validity of stop-flow estimates was verified by comparisons with direct puncture of glomerular capillaries in Munich-Wistar rats. Efferent arteriolar oncotic pressure was calculated from the filtration fraction and systemic protein concentrations. This calculation was verified in separate experiments by measurement of the protein concentration in blood collected directly from efferent arterioles. In 14 dogs, estimated glomerular capillary pressure (GCP) averaged 65.8 +/- 2.9 mmHg and proximal tubule pressure (PT) averaged 20.5 +/- 1.3 mmHg. The net hydrostatic filtration pressure (GCP - PT) of 45.3 +/- 2.7 mmHg was significantly higher than the efferent arteriolar oncotic pressure (piEA) of 33.2 +/- 2.8 mmHg (P less than .001). These findings indicate that filtration dynamics in the dog are characterized by filtration pressure disequilibrium.

Animals↗
PubMed2004

Kidney function in early diabetes: the tubular hypothesis of glomerular filtration.

At the onset of diabetes mellitus, the glomerular filtration rate becomes supranormal. Discovery science has identified many abnormalities in the early diabetic kidney that apparently contribute to this phenotype. A serviceable understanding of the early diabetic kidney requires this information to fit together. It is the purpose of this article to present an archetype that explains multiple nuances of kidney function in early diabetes. We refer to this archetype as the "tubular hypothesis of glomerular filtration." Its basic tenet is that strange effects of diabetes on glomerular filtration stem from primary effects on the proximal tubule or loop of Henle that impact glomerular filtration by feedback through the macula densa. This theory can explain diabetic hyperfiltration, a paradoxical effect of dietary salt on glomerular filtration rate in diabetes, and the renal response to dietary protein and amino acid infusion in diabetes. The discussion centers on the kidney as an integrated system of parts rather than on the specific cellular mechanisms that comprise those parts.

Animals↗
PubMed1985

Effect of parathyroid hormone on the determinants of glomerular filtration in dogs.

Elevated levels of parathyroid hormone (PTH) often are associated with reduced glomerular filtration rate (GFR) in humans. Although PTH has been reported to reduce the ultrafiltration coefficient (Kf) in rats, GFR declined only if they were plasma expanded. In contrast, PTH does not reduce GFR in dogs, despite filtration pressure disequilibrium. To evaluate this apparent discrepancy, the determinants of GFR were measured in acutely thyroparathyroidectomized dogs. In the absence (n = 8) and presence (n = 10) of synthetic bovine PTH, GFR was 29 +/- 3 and 26 +/- 2 ml/min; Single nephron glomerular filtration rate was 58 +/- 4 and 51 +/- 3 nl/min; glomerular plasma flow was 248 +/- 22 and 250 +/- 24 nl/min; glomerular capillary pressure was 58 +/- 2 and 61 +/- 3 mmHg; Bowman's space pressure was 19 +/- 2 and 19 +/- 1 mmHg; and systemic oncotic pressure was 19 +/- 0.8 and 18 +/- 0.5 mmHg. Average effective filtration pressure (EFP) was significantly greater in the presence (18.6 +/- 1.3 mmHg) than in the absence (14.6 +/- 0.9 mmHg) of PTH. Therefore, Kf per glomerulus calculated from these data was significantly (P less than 0.01) less in the presence than in the absence of PTH (2.91 +/- 0.29 and 3.98 +/- 0.16 nl X min-1 X mmHg-1, respectively). It is concluded that PTH reduced Kf. Whereas this effect predicts reduced GFR in dogs, given filtration pressure disequilibrium, a concomitant increase in EFP maintained GFR in the present study.

Animals↗
PubMed1989

Filtration fraction.noninvasive measurement with Tc-99m DTPA and changes induced by angiotensin-converting enzyme inhibition in hypertension.

Using a recently described new technique, individual kidney filtration fraction was measured from the first 3 min of the Tc-99m DTPA renogram in a series of 11 subjects without evidence of renal disease and in 23 patients with hypertension. Fourteen of these hypertensives had angiographic evidence of renal artery stenosis (RAS) but only 2 had proven renovascular hypertension (RVH). In addition, renal blood flow (RBF), expressed as a fraction of cardiac output, was measured from the first pass time activity curves following bolus injection of Tc-99m DTPA, and individual kidney glomerular filtration rate (IKGFR) was measured from the subsequent plasma Tc-99m DTPA clearance and renographic divided function. An estimation of filtration fraction based on these measurements of RBF and IKGFR correlated rather poorly with that directly based on the renogram, although both showed directionally similar changes in the hypertensive patients following inhibition of angiotensin-converting enzyme (ACE) with captopril. Filtration fraction by both estimates fell significantly after ACE inhibition in patients with RAS and essential hypertension, while RBF increased. IKGFR showed no change in essential hypertension or in hypertensive patients with RAS but fell sharply in 3 renal units in 2 patients with RVH. This renographic method for measuring filtration fraction is worthy of further elaboration and might be a simple and useful discriminator of RVH in a hypertensive population.

Adult↗