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PubMed2004

Living with a functioning kidney transplant at 74 yr or older: a national epidemiological study.

The number of older patients living with a functioning kidney graft is increasing. However the safety of the immunosuppressive treatment and quality of life in this population have not yet been determined. All patients grafted in France since 1969, born before the January 1 1926 and living with a functioning graft on January 1 2000 were included in this national study including all 34 French transplant centers. Renal function, immunosuppressive treatment, comorbid conditions and quality of life were assessed. From the initial population of 446 patients, 113 (26.2%) were still alive in 2000 (study population). Mean age was 76 yr (range: 74-80) with a mean post-transplant follow-up of 9.9 yr (0.1-28.7). Average serum creatinine level was 129 micromol/L (55-286). Immunosuppression was heterogeneous and included triple therapy (18.6%), dual therapy (41.6%) and monotherapy (40.8%). A history of cancer was noted in 36 of the 113 patients (32.1%) whereas hypertension was the most frequent co-morbid condition (80.3%). Estimated quality of life using the Karnofsky scale was between 80 and 100 in 78.4% of the patients. The immunosuppressive regimen in older renal transplant recipients living with a functioning graft varied widely among the 34 French transplant centers. Renal function in this group of patients was good and quality of life seemed excellent. Cardiovascular disease and malignancies were the main co-morbid conditions.

Aged↗
PubMed1980

A micropuncture study of kidney function in the river lamprey Lampetra fluviatilis adapted to sea water.

Micropuncture techniques have been used to investigate kidney function in lampreys adapted to hyperosmotic media. Plasma electrolyte concentrations were maintained well below corresponding concentrations in the external environment. Urine composition was variable, but generally showed high concentrations of magnesium, sulphate and chloride ions. Lampreys in 50% sea water produced urine which was hypo or iso-osmotic to plasma, whereas those in 100% sea water produced hyperosmotic urine. Urine flow rate in 50% sea water was one tenth of that in fresh water, due to a reduction in filtration rate and an increase in water reabsorption by the kidney. As in fresh water, little if any filtered water was reabsorbed by the proximal segment. Almost 90% of filtered water was reabsorbed by the kidney of 100% sea water lampreys and most of this must have occurred in the distal and collecting segments.

Adaptation, Physiological↗
PubMed1992

Determination of functional kidney volume by single-photon emission computed tomography in patients with insulin-dependent diabetes mellitus.

Functional parenchymal kidney volume was determined by single-photon emission computed tomography (SPECT) for 99mTc-dimercaptosuccinic acid (DMSA) using a rotating gamma camera in phantom experiments and in patients with insulin-dependent diabetes mellitus (IDDM). The results from the patient examinations were corrected according to the phantom studies and were thereafter set in relation to renal haemodynamics, blood pressure, and urinary albumin excretion. Functional parenchymal kidney volume was significantly greater in diabetic patients compared to that of 11 healthy controls (P < 0.003). Urinary albumin excretion was increased and glomerular filtration rate (GFR) per renal parenchymal volume significantly less in patients with a duration of diabetic disease of more than 15 years compared to patients with shorter duration of disease (P < 0.03 and P < 0.05 respectively). Diabetic patients with a GFR of more than 120 ml/min had greater renal parenchymal volume than patients with lower GFR (P < 0.02). Patients with increased GFR, renal plasma flow (RPF), renal blood flow, or filtration fraction had significantly greater functional parenchymal volume than the healthy subjects (P < 0.01 for all comparisons). We conclude that by application of SPECT for DMSA we were able to show that IDDM patients have greater renal parenchymal volumes than healthy subjects. GFR/kidney volume was increased in IDDM patients with a duration of disease of < 15 years compared to patients with long-standing diabetes. The SPECT technique seems suitable for prospective long-term follow-up studies of functional kidney volume in IDDM patients.

Adult↗
PubMed1980

[Quantitative kidney function scintigraphy (FSG) on separate sides in urogenital tuberculosis].

Depending on degree and size of the changes the function of the tuberculous kidney is disturbed with different strength. With the help of the quantitative function scintigraphy by means of 131 J hippuran (sequence scintigraphy, ROI nephrography and side-separated clearance) 33 patients with urotuberculosis were examined and their course of the disease was observed. The greatest value has the function scintigraphy in progressed renal tuberculosis in the differential therapy (nephrectomy, organ-maintaining operation or conservative therapy) and control of the course.

Creatinine↗
PubMed2005

Lead nitrate induced unallied expression of liver and kidney functions in male albino rats.

To determine the effects of lead where lead accumulates maximum (liver followed by kidney), liver and kidney functions were studied using low oral dose of lead nitrate for prolonged duration. Dose of 20 mg lead nitrate/kg body wt/day was used in male albino rats. AST and ALT levels altered independently. When ALT remained unaltered after 7 and 21 days of treatment, it is decreased by 13.21% after 14 days treatment. AST was marginally lowered after 7 days, increased after 14 days and increased marginally after 21 days. Bilirubin (conjugated, unconjugated and total) decreased after 7 and 14 days and increased after 21 days. Urea increase was directly proportional to duration. Creatinine remained unaltered.

Alanine Transaminase↗
PubMed1989

Effect of captopril on blood pressure and kidney function in normotensive insulin dependent diabetics with nephropathy.

OBJECTIVE: To assess whether inhibition of angiotensin converting enzyme protects kidney function in diabetic nephropathy. DESIGN: Open, randomised follow up study of normotensive insulin dependent diabetics with nephropathy either treated or not with captopril for one year. SETTING: Outpatient diabetic clinic in a tertiary referral centre. PATIENTS: 32 Normotensive patients with insulin dependent diabetes complicated by nephropathy who were randomised either to the treatment group (n = 15) or to the control group (n = 17). INTERVENTIONS: The treatment group was given captopril (25-100 mg/day) for 12 months, the average dose during the second six months of the study being 40 mg daily. Controls were not treated. MAIN OUTCOME MEASURES: Albuminuria, arterial blood pressure, and the glomerular filtration rate. RESULTS: Mean arterial blood pressure fell by 3 (SE 2) mm Hg in the captopril treated group and rose by 6 (1) mm Hg in the controls. In addition, albuminuria declined by 11% in the captopril treated group and rose by 55% in the controls, fractional albumin clearance fell by 17% in the captopril treated group and increased by 66% in the controls, and the glomerular filtration rate declined by 3.1 (2.8)ml/min/1.73 m2 with captopril and by 6.4 (3.1) ml/min/1.73 m2 in the controls. CONCLUSION: Inhibition of angiotensin converting enzyme arrests the progressive rise in albuminuria in normotensive insulin dependent diabetics with nephropathy.

Adult↗
PubMed1992

[Kidney function in pregnant women with primary arterial hypertension].

Investigations covered 64 women in the III trimester of pregnancy. In this group 34 were with diagnosed primary arterial hypertension (examined group), and 30 were apparently healthy (control group). In both groups the blood serum concentrations of creatinine, urea, uric acid and electrolytes were determined. Creatinine clearance and acid-base balance were determined in these cases also. In 24 hours urine samples the NH4+, H+, Na+ and K+ ions concentrations were established. Impaired kidney function was shown in the patients from the examined group.

Female↗
PubMed1989

Kidney function in newly diagnosed type 2 (non-insulin-dependent) diabetic patients, before and during treatment.

Glomerular filtration rate, kidney volume, and urinary albumin excretion rate were studied in otherwise healthy newly diagnosed Type 2 (non-insulin-dependent) diabetic patients, untreated at diagnosis, after short-term treatment and after 3 months treatment. In 10 patients (Group A) glomerular filtration rate (measured by the plasma clearance of 51-Cr-EDTA) decreased from the time of diagnosis 106.2 +/- 14.6 ml.min-1.1.73 m2(-1) (mean +/- SD) to 95.9 +/- 13.7 ml.min-1.1.73 m2(-1) after 3 months treatment (p = 0.049). At the same time, mean plasma glucose was reduced from 13.3 +/- 3.2 mmol/l to 6.5 +/- 1.1 mmol/l. The fall in mean plasma glucose was correlated to the reduction in glomerular filtration rate, r = 0.76, p = 0.011. Kidney volume as measured by ultrasonic scanning was reduced from 264.0 +/- 33.7 ml/1.73 m2 to 210.8 +/- 23.8 ml/1.73 m2 (p less than 0.005). The relative decline in urinary albumin excretion rate was correlated to the fall in glomerular filtration rate, r = 0.69, p = 0.026. In 15 patients (Group B) 24-h urine collections were made during 9.5 +/- 3.2 days, urinary albumin excretion rate fell from the first to the last day in hospital from 14.0 x/divided by 3.0 micrograms/min (geometric mean x /divided by tolerance factor) to 7.0 x/divided by 2.7 micrograms/min p = 0.015. The relative decline was correlated to the change in mean plasma glucose, r = 0.65, p = 0.032. Thus, kidney function in Type 2 diabetic patients is influenced by metabolic control, although to a lesser extent than is seen in Type 1 (insulin-dependent) diabetic patients with comparable glycaemic control.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed2002

Cyclooxygenase-2 and the kidney: functional and pathophysiological implications.

In adult mammalian kidney, cyclooxygenase-2 (COX-2) expression is found in restricted subpopulations of cells. High levels of expression can be detected in the macula densa (MD) and associated cortical thick ascending limb of Henle (cTALH) cells and medullary interstitial cells (MICs). In human biopsy specimens, COX-2 expression is also detected in glomerular podocytes and increased podocyte expression is seen in experimental models of progressive glomerular injury. Physiological regulation of COX-2 in these cellular compartments suggests functional roles for eicosanoid products of the enzyme. COX-2 expression increases in high-renin states (salt restriction, angiotensin-converting enzyme inhibition, renovascular hypertension) and selective COX-2 inhibitors significantly decrease plasma renin levels, renal renin activity and mRNA expression. There is evidence for negative regulation of MD/cTALH COX-2 by angiotensin II and by glucocorticoids and mineralocorticoids. Conversely, nitric oxide (NO) generated by neuronal nitric oxide synthase (nNOS) is a positive modulator of COX-2 expression. Decreased extracellular chloride increases COX-2 expression in cultured cTALH, an effect mediated by increased p38 MAP kinase activity and, in vivo, a sodium-deficient diet increases expression of activated p38 in MD/cTALH. In contrast to COX-2 in MD/cTALH, COX-2 expression in MICs increases in response to a high-salt diet, as well as water deprivation. Studies in cultured MICs confirm that expression is increased in response to hypertonicity, and expression is mediated at least in part by nuclear factor-kappaB (NFkappaB) activation. COX-2 inhibition leads to apoptosis of MICs in response to hypertonicity in vitro and following water deprivation in vivo. In addition, COX-2 metabolites appear to be important mediators of medullary blood flow and renal salt handling. Therefore, there is increasing evidence that COX-2 is an important physiological mediator of kidney function.

Animals↗
PubMed1995

Conjugate effects of saralasin and indomethacin on kidney function in anesthetized dog.

The intravenous administration of the cyclooxigenase blocking indomethacin results in a very rapid and sharp decrease of renal blood flow (RBF) and in a decrease of water and sodium excretion in anesthetized dogs. The result is very similar to that of the angiotensin II infusion. The present study was undertaken to examine in anesthetized dogs, how the angiotensin II receptor antagonist saralasin can influence the kidney function and the renal effects of the intravenously administered indomethacin. 0.2 micrograms/kg/min saralasin infused directly into the left renal artery induced a slight drop in the arterial blood pressure, and a slight but significant decrease in the renal vascular resistance without affecting other renal parameters. The intrarenal infusion of saralasin, when it preceded the administration of indomethacin, almost completely abolished the renal hemodynamic effects of indomethacin and decreased its effect on the renal water and sodium excretion. It seems therefore probable that in anesthetized dogs the renin-angiotensin system may play a role in the development of the renal effects of indomethacin.

Anesthesia↗
PubMed1975

[The influence of hydroxyethyl starch solutions on circulation and on kidney function in hypovolaemic patients (author's transl)].

In a group of 12 hypovolemic patients some parameters of circulation and kidney function were measured before and after an infusion of 1000 ml 6% hydroxyethyl starch solution (HES) was given. There were found increases in cardiac output, centralvenous pressure and endogenous creatinine clearance, and decreases of total peripheral resistance and shock index. Under the conditions of this investigation HES solution showed good properties as a plasma substitute.

Blood Circulation↗
PubMed2003

Effects of taurine and enalapril on kidney function of the hypertensive glucose-intolerant rat.

BACKGROUND: Recent studies indicate that the coexistence of hypertension and glucose intolerance leads to impairment in saline volume-induced diuresis and natriuresis. Furthermore, taurine and enalapril affect renal function and blood pressure (BP). Therefore, we tested the hypothesis that therapy combining taurine and enalapril would confer greater antihypertensive activity and responsiveness to saline volume loading in the hypertensive glucose-intolerant (HGI) rat than either agent alone. METHODS: Hypertensive (H) and HGI rats were treated from 6 weeks to 6 months with tap water containing no addition, taurine (0.25%), enalapril (15 mg/kg/day), or the taurine-enalapril combination. Hemodynamic and renal responses to an intravenous isotonic saline volume load were then determined in the conscious animal. RESULTS: The vehicle-treated HGI rats displayed reduced saline volume-induced diuresis and natriuresis relative to their H counterparts. Although none of the three drug regimens affected BP, they were similarly effective in increasing the renal excretory responses to saline volume loading and in eliminating differences that existed between the untreated H and HGI groups. Although reduced tubular reabsorption activity contributed to the taurine- and enalapril-mediated augmentation in renal excretory function, enalapril also enhanced glomerular function. The augmentation in the glomerular filtration rate was greatest in the HGI rat treated with the combination of taurine and enalapril. Furthermore, all three drug regimens significantly reduced protein excretion in both H and HGI rats. CONCLUSIONS: Despite exerting no influence on BP, all three drug regimens were renoprotective, as indicated by the drug-mediated improvement in kidney function of the HGI rat.

Angiotensin-Converting Enzyme Inhibitors↗
PubMed1989

Antigravity suit inflation: kidney function and cardiovascular and hormonal responses in men.

To investigate the effects of lower body positive pressure (LBPP) on kidney function while controlling certain cardiovascular and endocrine responses, seven men [35 +/- 2 (SE) yr] underwent 30 min of sitting and then 4.5 h of 70 degrees head-up tilt. An antigravity suit was applied (60 Torr legs, 30 Torr abdomen) during the last 3 h of tilt. A similar noninflation experiment was conducted where the suited subjects were tilted for 3.5 h. To provide adequate urine flow, the subjects were hydrated during the course of both experiments. Immediately after inflation, mean arterial pressure increased by 8 +/- 3 Torr and pulse rate decreased by 16 +/- 3 beats/min. Plasma renin activity and aldosterone were maximally suppressed (P less than 0.05) after 2.5 h of inflation. Plasma vasopressin decreased by 40-50% (P less than 0.05) and plasma sodium and potassium remained unchanged during both experiments. Glomerular filtration rate was not increased significantly by inflation, whereas inflation induced marked increases (P less than 0.05) in effective renal plasma flow (ERPF), urine flow, osmolar and free water clearances, and total and fractional sodium excretion. No such changes occurred during control. Thus, LBPP induces 1) a significant increase in ERPF and 2) significant changes in kidney excretory patterns similar to those observed during water immersion or the early phase of bed rest, situations that also result in central vascular volume expansion.

Adult↗