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PubMed2002

Chronic taurine treatment ameliorates reduction in saline-induced diuresis and natriuresis.

BACKGROUND: Taurine is an osmolyte found in high concentration in the kidney. Both the modulation of tissue taurine stores and the exogenous administration of taurine are known to affect renal function. Therefore, it is likely that taurine therapy could benefit the dysfunctional kidney. METHODS: To test this idea, the present study examined the effect of chronic taurine administration on the excretory responses to acute saline volume loading by the unilaterally nephrectomized (UNX) control and the UNX glucose-intolerant rat (ages 3 to 9 months). RESULTS: Sham-operated animals excreted similar amounts of the administered fluid and sodium loads with age. However, unilateral nephrectomy was associated with a significant reduction in the response to saline volume loading. This defect was prominent at a younger age (that is, 3 months) in the UNX glucose intolerant than the UNX control (6 months old) rat. Chronic taurine treatment ameliorated the reduction in saline-induced diuresis and natriuresis by both the UNX control and the UNX glucose intolerant rat. Both an increase in glomerular filtration and a reduction in tubular reabsorption of fluid and sodium caused this taurine-mediated improvement in renal excretory function. CONCLUSION: Taurine treatment protects the kidney of the UNX rat against an age-dependent decline in excretory efficiency.

Aging↗
PubMed1989

Analysis of reabsorbate concentrations in the proximal tubules of dog kidneys during osmotic diuresis.

To examine to what extent the reabsorbate concentrations, calculated as the flux ratios between solutes and water, represent the fluid composition in the lateral intercellular space (LIS) in the proximal tubules, reabsorption was stimulated by elevating PCO2 from 5 to 13 kPa before and during infusion of mannitol to a plasma concentration of 70 mM in volume-expanded dogs receiving ethacrynic acid. The reabsorbate concentration of NaHCO3 increased by 50 mM during mannitol infusion. The real concentration of NaHCO3 in LIS could not, however, be elevated by this amount, since the driving forces for fluid reabsorption then would have increased during osmotic diuresis due to diffusion of mannitol into LIS from plasma. A model analysis of diffusion in LIS showed that transcellular transport can only lead to trivial increases of LIS concentrations compared to plasma, whereas diffusion across tight junctions can increase LIS concentrations by several mM. NaCl diffusion and coupled transcellular water transport may therefore represent a significant contribution to total bicarbonate-dependent NaCl and water reabsorption in the proximal tubules.

Animals↗
PubMed1968

Depression of fractional sodium reabsorption by the proximal tubule of the dog without sodium diuresis.

The effect of infusions of hyperoncotic solutions on fractional sodium reabsorption by the proximal tubule of the dog was studied by the recollection micropuncture method. Tubule fluid to plasma inulin concentration ratios were measured for identified proximal tubule segments before and after infusion of 25% albumin or dextran solutions. Results were compared with changes in fractional reabsorption during saline diuresis. Plasma volume increased 66% +/- SE 5.8 after infusion of albumin solution and 94% +/- SE 8.2 after infusion of dextran solution. Fractional sodium reabosorption by the proximal tubule was depressed after infusion of both of these hyperoncotic solutions. Nevertheless, changes in sodium excretion after infusion of albumin and dextran were small. In contrast, after infusions of isotonic sodium chloride solution, which increased plasma volume 61% +/- SE 5.8, a decrease in fractional reabsorption of 50.7% +/- SE 7.2 was associated with large changes in sodium excretion.

Albumins↗
PubMed1995

Bioelectrical impedance analysis as an assessment of diuresis in congestive heart failure.

OBJECTIVE: To compare changes in bioimpedance parameters and calculated total body water (TBW) with conventional measurements used to assess the efficacy of diuretic therapy in the treatment of heart failure. SETTING: A Veterans Affairs tertiary care, teaching hospital. SUBJECTS: Twelve patients with New York Heart Association (NYHA) class III congestive heart failure (CHF). DESIGN: Prospective, consecutive sample, cohort, open label. INTERVENTIONS: Parenterally administered furosemide; clinically dictated, outcome-oriented, adjunctive therapy of CHF. OUTCOMES: Bioelectrical impedance analysis (BIA) parameters, measured volume of diuresis and changes in body weight, defined clinical endpoints (NYHA criteria). RESULTS: Three days of diuretic therapy with furosemide (oral and/or intravenous) for CHF was associated with a measured weight loss of 4.1 +/- 0.6 kg and statistically significant increases in resistance and reactance of 20.8% +/- 2.7% and 22.7% +/- 6.1%, respectively (p < 0.005). Calculated TBW using BIA parameters and standard equations decreased on average by 6.1 +/- 0.6 L or 11.2% +/- 1.1% (p < 0.001). A significant inverse correlation was observed between change in measured body weight and total body reactance (p = 0.02). CONCLUSIONS: Single-frequency BIA appears to have limited clinical usefulness as a method of assessing diuretic therapy in the management of CHF. Its greatest usefulness appears to lie in the assessment of serial changes in individual patients and patient populations that are physiologically or metabolically homogeneous. Further studies are needed to establish the validity of BIA in patients with decompensated CHF.

Administration, Oral↗
PubMed2001

Aggressive diuresis for severe heart failure in the elderly.

STUDY OBJECTIVE: To determine the efficacy, safety, and economic benefit of continuous IV infusion of furosemide as a treatment modality for elderly patients with class IV heart failure. DESIGN: Prospective trial of consecutively admitted elderly patients > 65 years old with class IV heart failure. SETTING: A single cardiovascular service in a university medical center. PATIENTS: Seventeen male and female patients > 65 years old consecutively admitted to a cardiovascular service. RESULTS: High-dose, continuous IV infusion of furosemide was successful in providing a 9- to 20-L diuresis in an average of 3.5 days without causing clinical complications or aberrations in blood chemistry. The length of stay was 2.3 days shorter than a contemporary group of class III and class IV elderly patients with heart failure managed on other medical services. The Medicare reimbursement for heart failure was $6,047. Patients receiving IV bolus diuretic therapy incurred billing charges of $10,193, or a loss of $4,146 per patient to the hospital. Patients receiving diuretic infusion therapy incurred billing charges of $4,944. This was a difference of $5,249 per patient treated by continuous IV infusion compared to bolus therapy and a profit per Medicare patient of $1,103. Therefore, a $4,146 billing loss was converted to $1,103 profit. CONCLUSION: IV furosemide infusion therapy for class IV heart failure in the elderly is a safe, effective, and economic mode of therapy.

Aged↗
PubMed1990

Effects of glutathione depletion, chelation and diuresis on iron nitrilotriacetate-induced lipid peroxidation in rats and mice.

1. Rats and mice dosed with iron nitrilotriacetate (FeNTA) i.p. (2-12 mg Fe/kg) showed evidence of lipid peroxidation as indicated by increased exhalation of ethane and increased malondialdehyde formation in liver and kidney. 2. Buthionine sulphoximine (BSO) administered i.p. to rats and mice decreased the total glutathione (GSH) content of liver and kidney. When the rodents were pretreated i.p. with BSO prior to injection of FeNTA the increases in ethane exhalation, and in liver and kidney malondialdehyde production, were greater than with FeNTA alone, and the total GSH of liver and kidney were decreased. 3. Diuresis produced by i.p. administration of furosemide to mice substantially decreased the ethane exhalation resulting from FeNTA administration, had a lowering effect on kidney MDA, but had no significant effect on liver MDA production. 4. Similarly, desferrioxamine beta-mesylate administered i.p. to mice markedly decreased the ethane exhalation and kidney MDA production resulting from FeNTA administration.

Animals↗
PubMed1990

[Urodynamic study of the upper urinary tract in the state of ureteral stenting--diuresis renography].

On 24 reno-ureteral units of 21 patients with a silicon ureteral stent, urodynamic study of the upper urinary tract was performed by diuresis radionuclide urography (DRU). We obtained the following conclusions. 1. A silicon stent was useful to maintain urinary stream in ureteral operation. 2. In extrinsic ureteral stricture due to pelvic malignant tumor, pattern of DRU was still poor after indwelling stent. 3. When a stent of the 5-8F's outer diameter was used for an adult, a too thick stent for the ureteral size might rather interrupt the urinary stream. 4. Patterns of DRU and GFR measured by Gates' method in the state of ureteral stenting could warns that hydronephrotic kidney may develop.

Furosemide↗
PubMed2001

Renal cortical scintigraphy and diuresis renography in infants and children.

Renal scintigraphy is performed frequently in infants and children. Renal cortical scintigraphy using 99mTc dimercaptosuccinic acid is predominantly performed to assess the renal sequelae of urinary tract infection. It is most commonly performed for the evaluation of chronic renal scars, although it is also undertaken in the assessment of acute pyelonephritis. Diuresis renography using 99mTc mercaptoacetyltriglycine is of great use in the evaluation of renal tract obstruction, which may occur at a variety of levels, but most commonly occurs at the ureteropelvic junction. Consensus statements have been formulated in an attempt to standardize methods of performing these investigations. However, several areas of controversy exist in the performance of these studies, and these are outlined. Radionuclide cystography and renal function estimation using clearance calculations are not covered in this article.

Child, Preschool↗
PubMed1975

Theory of hydrokinetic clearance of bacteria from the urinary bladder. II. Effects of "bound" organisms and diuresis.

When patients with urinary infection drink large volumes of water and empty the bladder at frequent regular intervals, the concentration of bacteria in the voided samples commonly falls rapidly at first and then remains almost constant. The present theoretical analysis leads to the conclusion that the rapid initial fall in concentration is a function of diuresis and that the subsequent constant output originates from bacteria bound to multiplication sites on the uroepithelium from which their progeny are shed into the urine.

Bacteriuria↗
PubMed2004

Vestibular diuresis in suspected Meniere patients.

OBJECTIVE: Diagnosis of Meniere's disease in patients without classical symptoms may present some difficulty. Detection of hydrops in patients with normal or near to normal hearing or presenting unpredictable balance problem with great variability of severity, periodicity and duration is the major concern in reaching the accurate diagnosis to start the therapy as early as possible. METHOD: To investigate the diagnostic role of vestibular diuresis, electronystagmographic (ENG) evaluation of 20 patients with "probable" or "possible" Meniere's disease before and after intravenous furosemid administration has been reviewed in a prospective and blinded study and the results have been compared with 20 age-matched control subjects. RESULT: Eleven of 20 patients with Meniere's disease (55%) and one of 20 subjects in the control group (5%) demonstrated canal paresis at initial ENG testing. Thirteen patients from Meniere group (65%) and 1 subject from control group (5%) demonstrated positive response to furosemid. Seven of 11 patients with canal paresis in the patient group (63.7%) and 6 of 9 patients with no canal paresis at initial testing demonstrated positive response (66%) to furosemid. No statistical difference between these 2 subgroups was found when compared as response to furosemid. It has been found that there is no clear correlation between the duration of the disease and the positive response to furosemid. CONCLUSION: It has been concluded that, although some limitation exists, the sensitivity of furosemid test for evaluation of vestibular function in Meniere's disease is promising as compared with controls.

Adult↗
PubMedDate not supplied

[Norepinephrine-induced pressor diuresis blockade as a possible cause of hypertension].

The effect of norepinephrine infusion at a constant rate (0.8 or 2.5 microg/kg/min), i.v.) on the diuiresis, sodium excretion with urine, glomerular filtration, and arterial pressure (AP) was studied in acute experiments on dogs. The sodium excretion was calculated as percentage relative to the filtration charge. Norepinephrine infusion at a constant rate of 0.8 microg/kg/min led to an increase in the urine volume, in the amount of excreted sodium with increased AP (pressor diuresis effect), and glomerular filtration with increasing AP, while the level of reabsorption remained unchanged. An increase in the infusion rate to 2.5 microg/kg/min, led to a decrease in the urine volume, the level of sodium excretion, and the rate of glomerular filtration. In this case, the AP level was higher than that in the first series of experiments, and the level of sodium reabsorption was increased.

Animals↗
PubMed1988

Lithium clearance as an indicator of proximal tubular sodium handling during furosemide diuresis.

To evaluate the use of the renal Li clearance as an indicator of proximal tubular Na handling during furosemide diuresis, clearance experiments were performed in conscious catheterized rats. Maximal depression of proximal Na reabsorption was induced by isotonic saline expansion (40 ml/hr) and under these conditions furosemide (7.5 mg/kg/hr) did not increase absolute or fractional clearance of Li. These results provide indirect evidence against the existence of a furosemide-sensitive Li reabsorption in the ascending limb of Henle. The increase of absolute and fractional Li clearance observed in nonexpanded animals given furosemide therefore most likely reflects inhibition of electrolyte reabsorption in the proximal tubules. Using Li clearance as a measure for Na output from the proximal tubules, the study provided information about the contribution of proximal and distal nephron segments to saline expansion natriuresis. The results indicate that the natriuresis is caused by enhanced delivery of Na from the proximal tubules, which is only partially compensated for by a load-dependent increase of absolute distal Na reabsorption, most likely occurring in the thick ascending limb of Henle.

Animals↗
PubMed1979

[Standardized forced diuresis and peritoneal dialysis in the therapy of organophosphorous poisoning (author's transl)].

In a case of severe poisoning with the organophosphorous insecticide methidathione standardized forced diuresis and peritoneal dialysis were performed for the first time in addition to the usual therapeutical procedures (e.g. repeated gastric lavage, induced diarrhea, atropine and intensive care). The course of the illness as well as the duration of the acute phase were significantly shorter than in comparable cases. No hazardous situation occurred after the first hours of treatment. The presence of the organophosphorous cholinesterase inhibitor or of its metabolites in the urine and the dialysate was proved by thin-layer chromatography.

Adult↗
PubMed1977

[Poisoning and forced diuresis].

The effect of two different methods of forced diuresis was investigated in two groups consisting of twelve patients. These groups were statistically selected from 86 cases with severe poisoning caused by hypnotic drugs, exhibiting a comparable metabolic and neurological symptomatology. Group 1 underwent the usual diuretic therapy group 2 was treated with standardised forced duiresis (SFD). In group 2 a significant higher hourly urinary output, a lower incidence of acidosis and more stability of the electrolyte balance were found. Therefore SFD was judged to be a useful help in elimination of hypnotic drugs.

Acidosis↗
PubMed1984

Hormonal response to acute diuresis--a comparative study of furosemide and azosemide.

We observed and compared the hormonal response to acute diuresis for 6 hours by orally administered furosemide 40 mg and azosemide 60 mg in normal male volunteers. The treatment resulted in significant urine volume increase with its peak during 1 to 2 and 2 to 3 hours after administration, and the 6-hour cumulative urine volume was 2488 +/- 163 ml in furosemide and 2930 +/- 109 ml in azosemide, respectively. The plasma noradrenalin concentration rose with the increase of urinary noradrenalin excretion, but plasma adrenalin remained unchanged in spite of its increased excretion. Serum aldosterone and plasma renin activity rose with resultant increase of urinary aldosterone excretion. Such a stimulation of the renin-angiotensin-aldosterone system was greater with azosemide than with furosemide. Plasma ADH and serum prolactin concentration was also increased. As compared with the furosemide responses, 1 to 2 hour delayed responses were observed in urinary adrenalin and noradrenalin, plasma renin activity, serum and urinary aldosterone, plasma ADH and serum prolactin. This was probably caused by delayed onset of the diuretic action in the case of azosemide. The findings suggested that the differences in the hormonal responses of the two drugs are mainly explained by the difference in their diuretic phase.

Adult↗
PubMed1984

Diuresis, dialysis, and hemoperfusion. Indications and benefits.

The author discusses the clinical indications for therapy to enhance removal of toxins; the methods available to enhance removal of toxins, including forced diuresis and control of urine pH, peritoneal dialysis, hemodialysis, and hemoperfusion; the kinetics of hemodialysis and hemoperfusion; and the pharmacokinetic prediction of the efficacy of hemodialysis and hemoperfusion.

Adult↗
PubMed1982

Cisplatin hydration with and without mannitol diuresis in refractory disseminated malignant melanoma: a southwest oncology group study.

In a prospective phase II randomized trial, a dose of 100 mg/m2 iv cisplatin every 3 weeks plus forced hydration with or without mannitol diuresis was tested in patients with previously treated advanced malignant melanoma. A total of 67 patients were evaluated: 33 not given mannitol and 34 in the mannitol arm. Two partial remissions (of 2+ and 6.5 months) were achieved in the no-mannitol arm and one complete response and four partial responses (of 1, 2, 2.5, 5.5, and 8 months) were seen in the mannitol arm. Moderate, severe, and life-threatening renal toxicity was less in the mannitol arm, and patients tolerated more doses of cisplatin. The renal toxicity occurred mostly after the first dose of chemotherapy and did not seem to be cumulative. Other side effects were comparable in both arms. We concluded that renal toxicity is less severe in patients treated with cisplatin, hydration, and mannitol and that the use of cisplatin alone or in combination with other active agent(s) should be considered for further evaluation in previously untreated patients with malignant melanoma.

Cisplatin↗