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At least 451 records · Page 25Linked to original sources
PubMed1996

Simultaneous diuresis cysto-urethrometry and multichannel urethral pressure profilometry in continent female dogs.

OBJECTIVE: To study a combined urodynamic technique for assessment of urethral closure and bladder storage function in female dogs. ANIMALS: 20 healthy, adult, sexually intact female dogs of various breeds. PROCEDURE: Urethral pressure profilometry and continuous urethral pressure registration during high-diuresis cystometry (cysto-urethrometry) were studied in dogs sedated with xylazine. Pressures were measured, using a flexible polyvinylchloride multichannel catheter connected to a perfusion system. Urine production and volume were determined by radionucleotide dilution analysis of urine samples. Urethral pressure profilometry was performed first, followed by cystourethrometry. Maximal urethral pressure and maximal urethral closure pressure of consecutive profiles and their mean values were determined. Closure pressure at its highest and lowest level and at micturition threshold and absolute and relative magnitude of urethral pressure variation were determined in the high-pressure zone of the urethra while the bladder filled, enforced by diuresis. Bladder pressure and volume at the micturition threshold and static compliance also were determined. RESULTS: Differences in mean and variance between variables listed were not significant. Urethral closure pressure varied from 5 to 67 cm of H2O during bladder storage. So-called unstable detrusor contractions were observed in 6 dogs. CONCLUSIONS: Several variables for the assessment of the dynamics of urethral closure and bladder storage function obtained by the technique reported here are reproducible. Values from this study are considered reference values for further studies. CLINICAL RELEVANCE: The reported technique can be helpful in the investigation of complicated urinary incontinence in female dogs.

Analysis of Variance↗
PubMedDate not supplied

[Conditioned reflex mechanism in the hypothalamic regulation of diuresis].

In chronic experiments on dogs with urethrae brought out to the skin of the abdomen and electrodes implanted in the hypothalamus, the possibility was studied of the involvement of a conditioned component in hypothalamic control of the kidneys activity under a direct action of electric current on a hypothalamus. The beat of a metronome and the experimental surroundings served as a conditioned stimulus, stimulation of the hypothalamus was used as an unconditioned one, and diuresis -- as a manifestation of the conditioned reflex. It was found that the conditioned mechanism is also involved in the complex mechanism of hypothalamic control of kidney activity. Such conditioned changes of diuresis may be effected in different functional states of hypothalamic nuclei.

Animals↗
PubMed1976

[The effect of "standardized forced diuresis" (SFD) on serum and urinary electrolytes(author's transl)].

The effect of standardized forced diuresis (SFD) on the serum and urinary electrolyte levels was investigated in 10 cases of severe self-poisoning with hypnotic drugs. Diuresis was initiated by furosemide and maintained at an hourly urinary ouput of 2 litres. Fluid and electrolyte substitution was carried out with a standardized electrolyte solution. Initiation and termination of the SFD was performed abruptly. The mean values of sodium, potassium, chloride and phosphorus in the urine varied widely at the beginning of the SFD, while the calcium and magnesium values varied only slightly. During SFD, urinary stabilization occured at a particular ionogram, in correlation to the electrolyte concentrations in the infusion fluid and with only minimal individual variation. Owing to this satisfactory correlation, none of the patients developed signs of electrolyte disturbances, so that no correction of the infusion constitution was necessary. The abrupt termination of the SFD prevented electrolyte disturbances in the recovery phase.

Adult↗
PubMedDate not supplied

Use of hemodialysis and forced diuresis in the treatment of poisoning.

This paper is a brief commentary of the role of forced diuresis and hemodialysis in the treatment of acute poisoning. The importance of informed conservative management is stressed. Rationale and methods of forced diuresis and urinary alkalinization are presented. Dialysis is reserved for special situations where shortening the poison-patient contact time is indicated.

Child↗
PubMed1980

Toxicity of cis-diamminedichloroplatinum II given in a two-hour outpatient regimen of diuresis and hydration.

A two-hour program of hydration with 2 liters of 0.45% saline-5% dextrose and diuresis with furosemide and mannitol was employed to administer cis-diamminedichloroplatinum(II) on an outpatient basis; 760 courses were administered to 158 patients. The dose was 50 mg/M2 every three to four weeks, and was given in combination with other anti-neoplastic agents in all but two patients. Only eight patients (5.13%) ever became azotemic. Of these, only three ever had serum creatinine determinations greater than 2 mg/dI, and azotemia was reversible in two months in all but one. Risk of azotemia did not increase with increasing cumulative dose. There were two anaphylactoid reactions, one sudden death, and two cases of hearing loss. Nausea and vomiting were universal, and often severe. This program of hydration and diuresis allows convenient outpatient administration of this drug with minor risk of mild nephrotoxicity.

Adult↗
PubMed1997

The benefit of low-dose dopamine during vigorous diuresis for congestive heart failure associated with renal insufficiency: does it protect renal function?

BACKGROUND: Low-dose dopamine, a renal vasodilator, has been used empirically to improve renal function or outcome in critically ill patients with oliguria or acute renal failure. HYPOTHESIS: This study was designed to investigate the efficacy of low-dose dopamine (2 micrograms/kg/min) as a renal-protective agent during vigorous diuresis for congestive heart failure (CHF) associated with mild or moderate renal insufficiency. METHODS: Of 20 study patients (mean age 74.3 +/- 15 years) with severe CHF, 10 (Group A) were randomized to a treatment strategy of intravenous bumetanide (1 mg b.i.d.) alone and another 10 (Group B) to low-dose dopamine and a similar diuretic regimen for a duration of 5 days or less if clinical edema remitted. RESULTS: Group B patients showed a significant improvement in renal function and urinary output: serum blood urea nitrogen 48.9 +/- 10.3 to 32.1 +/- 14.4 mg/dl (p < 0.05); serum creatinine 1.97 +/- 0.24 to 1.49 +/- 0.39 mg/dl (p < 0.05); creatinine clearance 35.6 +/- 11.6 to 48.8 +/- 12.3 ml/min (p < 0.05); and indexed urinary output 0.56 +/- 0.16 to 2.02 +/- 0.72 ml/kg/h (p < 0.05). Group A patients showed a significant increase in urinary output but nonsignificant renal functional deterioration. CONCLUSION: The renal-protective effect of low-dose dopamine in the setting of CHF and vigorous diuresis is supported by this study.

Acute Disease↗
PubMed2005

Unilateral temporary functional stasis in the upper urinary tract caused by "a filled bladder" on Tc-99m DTPA diuresis renography: a teaching case.

A 2-year-old girl with recurrent urinary tract infection having slight left pelvicaliceal dilatation on her renal ultrasound underwent a Tc-99m DTPA diuresis renography. During the excretion phase, a prominent and persisting left pelvicaliceal stasis was noticed even after the diuretic injection. However, it disappeared simultaneously with an uncontrolled micturition. This patient is presented to show the effect of filled bladder on the physiological drainage of urine. Since urine flow in the urinary system is more complicated than simple drainage, a thorough understanding of the physiological basis for diuresis renography and the pitfalls of the technique is required for its appropriate use in the management of patients suspected of urinary tract obstruction.

Artifacts↗
PubMed1997

Disprocynium24 induces a dopamine-independent, eukaliuric diuresis and natriuresis in the anaesthetized rat.

In the anaesthetized rat, intravenous administration of the isocyanine 1,1'-diisopropyl-2,4'-cyanine (disprocynium24) at doses up to 600 microg/kg resulted in marked diuresis and natriuresis without affecting urinary potassium excretion. Fractional sodium excretion was increased over 10-fold indicating a high ceiling-diuretic action. The effects of disprocynium24 on renal function were accompanied by a dose-dependent reduction in heart rate (HR) and mean arterial blood pressure (MAP). Acute administration of 600 microg/kg disprocynium24 decreased MAP by 25% and, in addition, caused a fall in glomerular filtration rate (GFR). Since i) disprocynium24 has been shown to interfere with urinary dopamine excretion (UDAV) and ii) dopamine has been implicated with the regulation of renal sodium excretion, we hypothesized that the effects of disprocynium24 might be mediated by its effects on renal dopamine handling. The following findings, however, argue against this hypothesis. First, administration of disprocynium24 in single doses up to 600 microg/kg caused a diuresis and natriuresis, but did not significantly affect U(DA)V. Second, neither the systemic nor the renal response to disprocynium24 were markedly altered by pretreatment with the dopamine D1- or D2-receptor blockers SCH23390 (10 microg x kg(-1) x min[-1]) or S(-)sulpiride (15 microg x kg(-1) x min[-1]), respectively.

Animals↗
PubMed1990

Diuresis in hemodynamically compromised patients: continuous furosemide infusion.

We have used continuous infusion of furosemide to achieve diuresis in patients who are stable but hemodynamically compromised after heart operations. With a loading dose of 20 mg and a continuous infusion of 4 to 10 mg of furosemide per hour, mean 24-hour urine output was 5.7 L (238 +/- 65 mL/h). Potassium replacement was 115 +/- 20 mmol [115 +/- 20 mEq/L]. Cardiac index, central venous pressure, and diastolic pulmonary artery pressure did not change significantly, even though hemodynamic support was decreased in each patient. Continuous furosemide infusion is a simple, effective, and reliable method to achieve diuresis in select patients.

Adult↗
PubMed1986

Tifluadom-induced diuresis in rats. Evidence for an opioid receptor-mediated central action.

Tifluadom dose-dependently induced diuresis in rats after subcutaneous injection and oral application. (+)Tifluadom was at least 100-fold more potent than the (-)enantiomer in inducing diuresis. The diuretic action of tifluadom was dose-relatedly reduced by the opioid receptor antagonists naloxone and MR 2266. Naloxone methobromide did not antagonize the diuretic effect of tifluadom nor did the benzodiazepine receptor blocker Ro 15-1788. These data demonstrate that the diuretic effect of tifluadom is mediated centrally via an agonistic interaction between the drug and opioid receptors.

Animals↗
PubMed2002

Impaired saline-stimulated diuresis and natriuresis in the conscious hypertensive glucose-intolerant rat.

BACKGROUND: A major complication of type 2 diabetes is renal dysfunction, a condition that worsens with coexistence of systemic hypertension. However, less is known regarding the renal impact of the prediabetic condition characterized by glucose intolerance. Therefore, we tested the hypothesis that chronic glucose intolerance leads to abnormal renal function, a condition also exacerbated by concurrent systemic hypertension. METHODS: A rat model of concomitant NaCl-sensitive hypertension and glucose intolerance was used to study renal function. Glucose intolerance was produced by administering streptozotocin to neonatal Wistar-Kyoto rats, and systemic hypertension was induced by combining dietary NaCl excess with unilateral nephrectomy. Hemodynamic and renal excretory responses were determined in conscious animals before and after administration of a 30-min isotonic saline challenge (5% of body weight, intravenously). RESULTS: Nine-month-old glucose-intolerant rats fed a normal NaCl diet did not manifest impairment in saline-stimulated diuresis and natriuresis. By contrast, 3-month-old glucose-intolerant rats fed a high NaCl diet displayed an exaggerated diuretic and natriuretic response to a saline challenge. Although saline-stimulated diuresis and natriuresis were enhanced in the hypertensive rats, they were reduced in the hypertensive glucose-intolerant animals. The reduction in renal excretory function of the latter group was caused by alterations in both glomerular function and tubular reabsorption of fluid and sodium. CONCLUSIONS: The coexistence of systemic hypertension and glucose intolerance result in impaired renal excretory function. This defect could be important, as hypertension can develop before the onset of overt type 2 diabetes.

Animals↗
PubMed1977

[The diuresis of cyclic adenosine-3'5'-monophosphate (cAMP) in primary and secondary disorders of the parathyroid glands].

The diuresis of cAMP in primary hyperparathyroidism was significantly higher at 7.3 +/- 2.5 mumol/g creatinine X 24 h (P less than 0.005) than that in healthy subjects (3.5 +/- 0.7 mumol/g creatinine X 24 h). After successful operation on the parathyroid gland, cAMP diuresis usually decreased within 24 hours to normal or subnormal values. In primary or secondary hypoparathyroidism subnormal amounts of cAMP (P less than 0.005) were excreted. The method gives false-negative results in functional disorders of the parathyroid glands accompanied or caused by renal failure.

Creatinine↗
PubMed2002

Is induction of fetal diuresis with intraamniotic furosemide effective for the removal of intestinal waste products from amniotic fluid?

AIM: In gastroschisis, contact with amniotic fluid (AF) causes intestinal damage. Intraamniotic meconium has been shown to be responsible for the intestinal damage, and intestinal damage has been shown to correlate with intraamniotic meconium concentrations. Intraamniotic meconium below a threshold level does not cause intestinal damage. Intraamniotic meconium concentrations can be lowered by AF exchange. Can induction of foetal diuresis by an intraamniotic injection of furosemide be used as an alternative method for the same purpose? METHOD: Pregnant rabbits on the 23rd - 25th gestational days (normal gestation time: 31 - 33 days) were divided into two groups, the control group and the furosemide group. Initial AF samples were taken, then either 5 mg/kg furosemide or a placebo was injected into the amniotic cavity. Final AF samples were obtained 6 hours later. AF urea nitrogen, creatinine, amylase, alkaline phosphatase and bilirubin levels were determined. RESULTS: There was no significant difference between the initial and final levels of AF urea nitrogen, creatinine, bilirubin, amylase, and alkaline phosphatase in the control group, while the final AF urea nitrogen and creatinine levels of the furosemide group were not significantly different from the initial levels (p > 0.05). Final AF bilirubin, amylase and alkaline phosphatase levels of the furosemide group were significantly decreased compared with initial levels (p < 0.01). CONCLUSION: Induction of foetal diuresis with intraamniotic furosemide is effective for the removal of intestinal waste products from amniotic fluid.

Amnion↗
PubMed1993

Postoperative diuresis renography and ultrasound in patients undergoing pyeloplasty. Predictors of surgical outcome.

The authors reviewed 50 pediatric patients (56 renal units) who underwent pyeloplasty and had serial preoperative and postoperative diuresis renogram and ultrasound studies. Of those patients that clinically improved with surgery, 73% and 91% showed improved renographic patterns in postoperative studies at 3 and 12 months, respectively. Ultrasound demonstrated more gradual improvement in grade and pelvic diameters over longer study intervals. Diuresis renography is an excellent predictor of surgical outcome within 3 months of pyeloplasty and showed change well in advance of that seen on ultrasound. Sonography is better suited to longer term evaluation of grade, pelvic diameter, and renal size.

Adolescent↗
PubMed1998

A prospective randomized trial comparing 2 diuresis renography techniques for evaluation of suspected upper urinary tract obstruction in children.

PURPOSE: We compare the diagnostic impact of 2 diuresis renography techniques for evaluation of suspected upper urinary tract obstruction in children. MATERIALS AND METHODS: A total of 72 children were randomly assigned to 1 of 2 standardized diuresis renography protocols. The protocols were identical, except for the time of furosemide (F) injection. In the F+20 scans furosemide was given 20 minutes after the 99mtechnetium pentetic acid radiopharmaceutical. With the modified F-15 scans furosemide was injected 15 minutes before renography. Hydration, bladder catheterization, urine output determination, radiopharmaceutical injection and scan acquisition were identical. Renography outcomes (obstructed, nonobstructed or equivocal) were analyzed for the investigated side(s) and for the contralateral side, which was used as a control in children with suspected unilateral obstruction. Chi-square test was used to compare the percentage of obstructed and nonobstructed scans of both protocols. Fisher's exact test was used to compare the nonobstructed scans and equivocal results of both protocols. RESULTS: Of the 96 scans performed 8 were excluded because of technical problems. The remaining scans included 44 F+20 and 44 F-15. Of the 88 scans 10 were used to evaluate possible bilateral obstruction. A total of 48 boys and 24 girls were evaluated. Because 2 children had a solitary kidney each, the total number of renal units studied for outcome was 174. The F-15 scan showed 7 times more obstruction than the F+20 scan on the investigated side, and this difference was statistically significant. No obstruction was diagnosed on the contralateral side with either technique when used to investigate cases of suspected unilateral obstruction. CONCLUSIONS: The timing of the furosemide injection (F-15 scan versus F+20) has a significant impact on the obstructive versus nonobstructive renography results when evaluating children with suspected upper urinary tract obstruction.

Child, Preschool↗
PubMed2005

Overnight catheter drainage in children with poorly compliant bladders improves post-obstructive diuresis and urinary incontinence.

PURPOSE: Overnight catheter drainage (OCD) has been suggested as a treatment for boys with valve bladder syndrome as well as those with polyuric renal failure. We report our experience using overnight catheter drainage in children with poorly compliant bladders. MATERIALS AND METHODS: Between 1999 and 2004 OCD was initiated in 6 boys and 5 girls (median age 7.5 years) with poorly compliant bladders in whom aggressive daytime intermittent catheterization and anticholinergic use had failed. Etiologies of bladder dysfunction included posterior urethral valves in 1 case, The Hinman-Allen syndrome in 4, myelomeningocele in 2, neuroblastoma in 1, prune-belly syndrome in 1, transverse myelitis in 1 and sacral agenesis in 1. The amount of post-obstructive diuresis was calculated during urodynamics as the volume drained minus volume instilled divided by weight per hour. Other parameters evaluated included serum creatinine, degree of upper tract dilatation, and episodes of urinary tract infection (UTI) and incontinence. RESULTS: Median duration of OCD and followup was 28 months, respectively. One patient did not tolerate overnight drainage. Of 9 patients who were incontinent before OCD daytime urinary incontinence resolved in 6 and improved in 3. Recurrent febrile UTIs in 3 children were eliminated. Despite no change in serum creatinine with overnight drainage, 7 of 8 patients (88%) with upper tract dilatation improved on followup ultrasound. CONCLUSIONS: In select children with poorly compliant bladders OCD reduces diuresis, reduces the frequency of UTIs, improves upper tract dilatation and improves continence. Overnight drainage in conjunction with daytime clean intermittent catheterization may prove to be an alternative to bladder augmentation in select children with poorly compliant bladders and early stages of renal compromise.

Adolescent↗
PubMed1992

The importance of renal function in the interpretation of diuresis renography.

Interpretation of the diuresis renogram is dependent on a full understanding of the factors that contribute to the washout curve, a major determinant being the urinary flow rate induced by the diuretic. Frusemide-induced flow rates were measured in 86 patients over a 30-min period and related to creatinine clearance in 39, 99mTc-DTPA clearance (glomerular filtration rate (GFR)) in 27, and 123I-Hippuran clearance (effective renal plasma flow) in 20. The flow rates 3 to 6 min and 15 to 18 min after administration of the diuretic received specific attention because of their importance to F + 20 and F - 15 diuresis renography respectively. The mean urinary flow rate 15 to 18 min after frusemide was 3.5 ml/min greater than at 3 to 6 min (P less than 0.001), explaining the value of the F - 15 renogram in further evaluating equivocal F + 20 curves. Linear relationships were observed between each parameter of function and the 3 to 6 min and 15 to 18 min periods as follows: creatinine clearance r = 0.66, r = 0.77; 99mTc-DTPA clearance r = 0.66, r = 0.77; 123I-Hippuran clearance r = 0.59, r = 0.71. From regression analysis of the data presented it is possible, with knowledge of total and split function, to predict single-kidney flow rates. It is demonstrated that these may commonly exceed flow rates used for perfusion studies if function is normal, but a single-kidney flow rate of 10 ml/min is unlikely to be attained if the single-kidney GFR is less than 15 ml/min.

Adult↗