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PubMedDate not supplied

Effect of prenatal and postnatal exposure to lead on kidney function in male and female rats.

The effect of 5 months' exposure to 0.5% lead acetate in drinking water on the kidney function of developing rats was studied. In both sexes, lead exposure produced a significant elevation of the kidney weight and after 3 months' treatment both male and female rats showed signs of tubular impairment. In male rats increased beta 2-microglobulin and lactate dehydrogenase excretion was observed. Lysozyme was increased after 5 months of exposure. No changes were observed in total proteins and albumin excretion. Female rats showed a significantly increased excretion of beta 2-microglobulin from 3 months onwards, while lactate dehydrogenase increased only at the end of 3 months and total proteins after 5 months of exposure. No changes were observed in lysozyme and albumin excretion. Thus, the results suggest that lead exposure produces changes in the renal tubular function of developing rat. There is no sex difference in the nephrotoxicity of lead. Comparison with our previous studies suggests that exposure to lead starting at weaning is more renotoxic than exposure starting 2 months later. However, prenatal exposure might also have been a contributory factor.

Albuminuria↗
PubMed1989

Transluminal angioplasty in patients with bilateral renal artery stenosis or renal artery stenosis in a solitary functioning kidney.

Renal angioplasty in patients with bilateral renal artery stenosis or with renal artery stenosis in a solitary functioning kidney has been thought to be relatively contraindicated. We report the results of renal artery angioplasty in 18 patients, 10 with severe bilateral renal artery stenosis and eight with severe renal artery stenosis in a solitary kidney. Twenty-five (89%) of 28 angioplasties were successful, with a mean improvement of the degree of stenosis from 85% to 18% after angioplasty and a restoration of renal blood flow. A significant drop in mean blood pressure at admission of 187/101 mm Hg to 154/87 mm Hg at discharge, 152/86 mm Hg at 3-month, and 146/82 mm Hg at 1-year follow-up was seen. Because of the decrease in blood pressure, 11 of the patients decreased or stopped taking diuretics and 15 decreased or stopped taking antihypertensive medications. Although no significant change in renal function was found by measuring mean serum creatinine levels over time, no patient had an elevated serum creatinine level at follow-up, indicating preservation of renal function. One major complication, cholesterol embolization to the bowel, was seen. Our results suggest that angioplasty is an acceptable treatment of hypertension in patients with bilateral renal artery stenosis or renal artery stenosis in a single kidney.

Aged↗
PubMed2005

The impact of anaemia and kidney function in congestive heart failure and preserved systolic function.

BACKGROUND: The importance of anaemia in chronic heart failure was highlighted recently by different cohort studies. The aim of this study was to assess the prevalence of anaemia and its relationship to renal function, left ventricular function and symptoms of heart failure. METHODS: We surveyed cases of patients admitted to the Department of Cardiology during 22 consecutive months. Laboratory measurements, blood pressure and echocardiographic parameters were obtained with standardized methods. RESULTS: Out of a total number of 2941 patients, 238 patients (8.1%) had haemoglobin values <11 g/dl. There was a positive association of anaemia with the symptoms of heart failure with a lowering of the median haemoglobin from 14.2 g/dl [New York Heart Association (NYHA) I] to 12.9 g/dl (NYHA IV, P<0.001). Interestingly, anaemia was not associated with left ventricular function or any left ventricular parameters. Symptoms of heart failure, however, were associated with kidney function. The estimated glomerular filtration rate (GFR) was 82 ml/min at NYHA I and 59 ml/min at NYHA IV, P<0.05. There was an association between impaired renal function and haemoglobin values. Haemoglobin was 14.2 g/dl in the group with normal renal function and 11.1 g/dl in the group with a GFR <25 ml/min (P<0.001). Even in patients with normal renal function (878 patients, GFR >85 ml/min), we still found an association of anaemia with the symptoms of heart failure. Haemoglobin was 14.5 g/dl at NYHA I and 13.4 g/dl at NYHA IV, P<0.0001. CONCLUSION: Anaemia is found in 8.1% of patients admitted to cardiology service. Anaemia was clearly associated with symptoms of congestive heart failure even in patients with normal renal function. Anaemia was not associated with left ventricular function.

Aged↗
PubMed1994

Comparison among the effects of oral, intraperitoneal and intravenous fluid-loading on kidney function and drinking in goats.

The effects of hyperhydration, induced by oral loading via a stomach tube (41 of 0.9% NaCl within 2-3 min), intra-peritoneal and intra-jugular infusions (41 of 0.9% NaCl solution at a rate of 21 hr-1) in normally hydrated goats, on fluid retention, plasma expansion, kidney function and drinking response were compared. Higher fluid retention (67 and 65% vs. 40% at 3 hr after the termination of the infusion, P < 0.01), attenuated diuretic (P < 0.01) and natriuretic (P < 0.01) responses and lower expansion of plasma volume (P < 0.05) were recorded in the orally and intra-peritoneally treated goats in comparison with the intra-jugularly treated animals. Portal expansion apparently induces acceleration of saliva secretion which recycles water to the gut. Recycling of water to the gut reduced excessive expansion of plasma fluid and load on the kidney. Retention of water in the rumen satiated the urge to drink in the orally and intra-peritoneally treated goats for at least 24 hr. The intra-jugularly treated goats consumed a significant amount of water (1l), which was approximately half of their normal requirement. Under arid conditions, these responses are appropriate to the animals' regular exposure to severe dehydration and rapid rehydration.

Administration, Oral↗
PubMedDate not supplied

Ureteric lesions detected in normally functioning kidney allografts: risk factors and clinical implications.

INTRODUCTION: We characterized the alterations in ureteral biopsies from normally functioning kidney allografts to study risk factors. MATERIALS AND METHODS: We studied 55 ureteral fragments from kidney grafts obtained during cystoscopy for routine double-J stent extraction. We evaluated the type and severity of the lesions, the risk factors for their occurrence, and their relation to the evolution of the transplant, including the occurrence of renal rejection episodes or ureteral complications. RESULTS: Borderline or rejection lesions were detected in 21 of the 55 fragments. Rejection lesions were more common among biopsies performed in the first 80 days (54.6%) than during the 120 days afterward (15.4%, P = .043). Similarly, urothelium reactivity was detected in 71.4% and 30.7% of the biopsies performed up to and after 4 months, respectively (P = .008). Urothelial atrophy was detected in 20% of the fragments, the age of the donors being higher in these cases (P = .026). There was a trend to the association of borderline or rejection lesions in the ureteral biopsies and a history of an acute renal rejection episode (P = .053). There were no detectable relations between those findings and the evolution of the transplant. CONCLUSIONS: Thirty-eight percent of the biopsed ureters showed rejection or borderline lesions, these lesions were more common among biopsies done in the first months after transplantation. These findings are similar to the ones found in routine renal biopsies. We did not find any significant relation between the nature of the lesions encountered on the ureteral biopsies and the evolution of the transplant.

Adolescent↗
PubMed1976

[Metabolic changes and assessment of kidney function after supercooling of the free-prepared kidney in animal experiment].

Aside from immunological problems, successful renal transplantation depends on preservation, properly maintaining its vitality and functional efficiency, also after transplantation. Complete restitution, slight functional less, reversible and irreversible renal failure, occurred according to chosen temperatures in the experiments. The best results were obtained at temperatures between 0 and +5 degrees C., mainly at an average value of +3C degrees. Irreparable renal damages developed at temperatures between 0 and -3 degrees C.

Acid-Base Equilibrium↗
PubMed1982

[Importance of the renal interstitium for kidney function].

After presentation of the structure of the cortical interstitium, numerous examples are cited illustrating the significance of the cortical interstitium for the function of the glomeruli and the tubular epithelium. Details are presented showing that every form of interstitial fibrosis increases the resistance of the postglomerular capillary network through the obliteration of the postglomerular capillaries and therefore negatively influences the function of the filter organ by hindering the outflow of blood from the glomeruli. It is also shown that, when glomerular involvement is isolated (e.g., glomerulonephritis, amyloidosis), even the most severe forms of glomerular nephropathy do not compromise the excretory function of the kidneys if the tubular epithelium and the intertubular capillaries are intact. On the basis of these findings, it is concluded that uremia does not develop in isolated glomerular nephropathy, but that the tubulo-interstitial system is also involved when the serum creatinine concentration is slightly increased in the various forms of "glomerular disease".

Acute Kidney Injury↗
PubMed1980

[Comparison of the effects of gastroenteric and parenteral saline loading on kidney function after inhibition of prostaglandin synthesis (author's transl)].

UNLABELLED: We inhibited the prostaglandin synthesis with indomethacin in rats during a 7-h (periods: 1--4h; 4--5.5h; 5.5--7h) gastroenteric and parenteral infusion of isotonic saline. Indomethacin was given in a dosis of 10 mg/kg of b. wt. by stomach tube after 5.5-h infusion of saline. We studied how far prostaglandins are involved in the different function of the kidney by measuring the water and sodium excretion and the cortico-medullary osmotic and albumin concentrations of the kidney. RESULTS: 1. a) Studies Without Indomethacin. As compared to infusion of isotonic saline into the stomach water excretion is decreased by 30% (P less than 0.02) and 35% (P = n.s.) in the second and third 90 min period during parenteral infusion of saline. As compared to gastroenteric infusion we found an increase of the total osmolarity by 13% (P less than 0.02) in the cortex of the kidney. b) Studies with Indomethacin. As compared to saline infusion into the stomach indomethacin-treated rats decrease their urinary flow rates in 90 min by 26% (P = n.s.) in the presence of equivalent saline infusion into the aorta. Total osmolarity of the parenteral loaded rats increases by 17% (P less than 0.01) in the cortex of the kidney. 2. Indomethacin leads to an increased concentrating ability of the kidney in both gastroenteric and parenteral loaded rats. 3. In the presence of indomethacin plasma albumin of the kidney increases in the cortex and in the outer medulla of the kidney. In the inner medulla, and in the papillary tip, however, albumin concentration decreases significantly. As compared to gastroenteric saline infusion, the osmolarity of the kidney tissue increases and the urinary flow rate decreases during equivalent parenteral infusion of isotonic saline. The prostaglandins are not responsible for the pronounced diuresis during infusions of isotonic saline into the stomach.

Animals↗
PubMed2000

[Spirapril - a new long-acting ACE inhibitor: efficacy and safety in patients with arterial hypertension in combination with diabetes mellitus and impaired kidney function].

AIM: To examine effectiveness and safety of quadropril. MATERIAL AND METHODS: Changes in blood pressure (BP), heart rate (HR), levels of glucose, potassium and creatinine, creatinine clearance were studied in 120 patients (48 males and 72 females, mean age 60.6 +/- 0.7 years) with mild to moderate arterial hypertension (AH) with average duration 13.8 +/- 0.7 years. The patients were divided into 3 groups: with AH (n = 40), AH + noninsulindependent diabetes mellitus (DM) (n = 43), AH and nephropathy (n = 37). 8-week treatment was performed with a standard dose of 6 mg/day (1 tablet of quadropril). Control examinations were made 2, 4 and 8 weeks after the treatment. RESULTS: After 8 weeks of treatment a decrease in systolic blood pressure in AH group was 24.0 +/- 3.0 mm Hg and in diastolic blood pressure 16.3 +/- 1.3 mm Hg (P < 0.001). In the group with DM this decrease was 22.4 +/- 2.8 mm Hg and 15.7 +/- 1.4 mm Hg (p < 0.001), respectively. In the group with nephropathy this decrease was 26.4 +/- 2.4 and 16.5 +/- 1.3 mm Hg (p < 0.001), respectively. Heart rate changed significantly only in diabetics: from 75.1 +/- 1.7 to 72.9 +/- 1.3 beats/min. Biochemical parameters in the hypertensive and diabetic patients did not change significantly. In the nephropathy group there was a significant decrease in creatinine and increase in creatinine clearance. Their level of glucose and potassium changed insignificantly. CONCLUSION: The treatment with quadropril results in a significant decrease in blood pressure, does not influence parameters of carbohydrate metabolism, improves nitrogen eliminating function of the kidneys.

Administration, Oral↗
PubMed1989

[Central hemodynamics and kidney function in women with pre-eclampsia].

A radionuclide method with quickly disintegrating 99MTC labelled human albumin and DTPA in a volume of 0.3-0.5 ml and activity of 37 mVk with two consecutive examinations of central and renal hemodynamics was used in 91 pregnant women with preeclampsia and pyelonephritis. Marked hypovolemia was found in all groups of investigated women with preeclampsia with the exception of the group of women with pyelonephritis. There was also difference in arterial pressure in women with preeclampsia I degree and pyelonephritis, which was statistically significant with advancement of gravity and duration of the disease. The investigation of the functional state of kidneys and blood flow showed a tendency to slowing both in the arterial and venous circulation in women with pre-eclampsia of pregnancy. In the pregnant women of this group and the women with pyelonephritis there was asymmetry in the curves of the blood flow as well as in the temporary indices of renal filtration, which were increases two-folds in comparison with the normal values. They were mostly manifested on the side of the involvement in women with pyelonephritis. Irradiation loading was 0.212 mZv of both examinations and was ten times less than that of x-ray pelvimetry.

Adolescent↗
PubMed1997

Kidney function after 1:1 conversion to the cyclosporine microemulsion formulation in children with liver allografts.

BACKGROUND: One-to-one (mg:mg) conversion from the conventional to the microemulsion formulation of cyclosporine (CsA) is advocated as a simple way to use the new therapeutic regimen. However, the potentially harmful effects of the conversion on kidney function in nonrenal transplant recipients are poorly known. METHODS: Renal effects of the conversion were prospectively investigated in 22 pediatric liver transplant recipients (mean age, 8.4 years; mean time from transplantation, 3.2 years). Patients were followed for 12 months. Pharmacokinetic studies were performed at baseline and 5 days and 6 and 12 months after conversion. RESULTS: Peak concentration, minimum concentration, average steady state concentration, and area under the concentration-versus-time curve increased by 60-130% after conversion. Graft losses, progressive deterioration of graft function, and acute rejection episodes did not occur. The mean glomerular filtration rate (GFR) was 103 ml/min/1.73 m2 at baseline and 100 ml/min/1.73 m2 after 12 months. However, 6 of the 22 patients showed at least a 15% (range, 16-38%) decrease in GFR between baseline and 6 months (P<0.01). They had a significantly higher increase in average steady state concentration between baseline and 6 months than the six patients with the best outcome in GFR during the same time period (164 ng/ml vs. 53 ng/ml, P<0.05). At this point (6 months), target CsA trough levels were reduced by 20-30%, while the mean area under the concentration-versus-time curve remained above that obtained at baseline. The GFR of three of the six patients subsequently improved. CONCLUSIONS: One-to-one conversion can be performed safely in liver transplant recipients if strict follow-up is feasible.

Adolescent↗