Clinical evaluation of kidney function--tubular function.
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A complex study of hemodynamics and renal function in 30 patients with adenoma of the prostate during peridural anesthesia has been carried out. The functional renal reaction depends upon the scope of the sympathetic blocade in peridural anesthesia and bears an intimate relation to hemodynamic and neurohumoral effects of the developing blocade. All these changes are of a temporary character and regain values close to the initial ones by the time of the adaptation of the body to peridural anesthesia and stabilization of hemodynamics.
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After single administration of potassium dichromate or glycerol, renal PAH excretion was markedly reduced in adult, but not in newborn and infant rats. As already demonstrated in rats with intact kidney functions, repeated administration of PAH or cyclopenthiazide stimulates also renal PAH excretion in rats with acute renal failure. In detail, after PAH or cyclopenthiazide treatment of rats the duration of injury is shortened whereas the intensity of the nephrotoxic effects is not changed. However, the stimulation depends on the age of animals as well as on the nephrotoxic agent administered.
In 153 children suffering from various renal or urological disease a total of 179 individual and regional renal clearance studies were performed using 123-I-hippuran and a scintillation camera. The clinical diagnoses and questions before and the therapeutic consequences after clearance determinations are analyzed. The dynamic information fo sequential scintigraphy combined with renal clearance determination allow a quantitative estimation of the individual and regional kidney function. The method is considerably helpful in cases of unilateral small kidneys, obstructive uropathies, duplication of the urinary tract, and segmental renal disease.
Osteocalcin or bone Gla protein (BGP) is the most abundant noncollagenous protein of the skeleton. Serum BGP levels are thought to provide a valuable index of bone formation. We measured serum BGP and other parameters of mineral metabolism in 68 patients with functioning kidney grafts. The duration of the graft ranged from 1 to 131 months (mean 23). Serum BGP was positively correlated with parathyroid hormone (r = 0.56, p less than 0.001). BGP was inversely correlated with glomerular filtration rate (r = -0.44, p less than 0.001) and with the total cumulative dose of corticosteroids received after transplantation (r = -0.26, p less than 0.05). No correlation was observed between BGP and 1,25(OH)2D, nor between BGP and serum aluminum. All patients with increased BGP in the presence of normal renal function had persistent hyperparathyroidism. The activity of the parathyroid glands and corticosteroid treatment seem to be the main pathophysiological factors influencing BGP levels after successful kidney grafting.
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The effect of cholagogic drugs on blood plasma content of natriuretic hormone (NH) in 41 patients with chronic opisthorchiasis was studied. The drugs were found to exert no effect on NH content and the kidney function in this pathology. The use of essentiale in patients with persistent hepatitis and cirrhosis of the liver was shown to increase sodium excretion due to an increase of NH content.
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