[The usefulness of simplified clearance method as kidney function tests].
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The phenolsulphthalein 60/60 plasma test (PSP 60/60) was evaluated in 30 control subjects (mean value 51 micrograms/100 ml +/- 49 micrograms/100 ml) and 60 patients with chronic renal disease with varying degrees of renal insufficiency. PSP 60/60 proved to be superior to determination of serum creatinine and urea nitrogen. PSP 60/60 correlated well with endogenous creatinine clearance and 131I-iodohippurate clearance in over 80% of cases. Of various exogenous and endogenous factors interfering with the test, drugs influencing renal excretory mechanisms are most important. Due to its technical simplicity, PSP 60/60 is a useful screening test for evaluation of renal function, especially as an office procedure.
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Thirty-two patients with hypertension were given a pressor dose of angiotensin in the course of individual kidney function tests. In eight patients with unilateral renal artery stenosis the differences in urine sodium and creatinine concentration between the affected and the nonaffected kidney did not become greater with angiotensin infusion. In four patients with unilateral pyelonephritis and falsely positive individual kidney function tests, these tests became normal following angiotensin infusion. It is concluded that angiotensin infusion is not a useful means of improving the results of individual kidney function tests.
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The role of the split kidney function tests in the diagnosis of renal hypertension is reviewed, and a new technique is described which is designed to diminish the number of false negative results sometimes encountered in unilateral pyelonephritis and segmental renal arterial stenosis. Split kidney function tests still have an important role in diagnosis of renal hypertension, particularly when the results of other investigations are equivocal and when facilities for differential renal renin assay are not available.
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