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At least 667 records · Page 37Linked to original sources
PubMed1984

Ultrasonographic renal parenchymal volume related to kidney function and renal parenchymal area in children with recurrent urinary tract infections and asymptomatic bacteriuria.

A comparison of the relationship that might exist between ultrasonographically calculated renal parenchymal volume and renal parenchymal area assessed from urography and also between renal parenchymal volume and kidney function was conducted in a series of 26 children with recurrent urinary tract infection or asymptomatic bacteriuria. Glomerular filtration rate (GFR) was determined by the clearance of inulin, renal parenchymal area was measured from urography and renal parenchymal volume was calculated from sequential longitudinal scans of the kidney using an automated water-delay ultrasonographic equipment (Octoson). High correlation was found between 1) renal parenchymal volume and GFR, 2) renal parenchymal volume and renal parenchymal area and 3) renal parenchymal area and GFR. Octoson ultrasonographic determination of renal parenchymal volume is a reliable method to evaluate glomerular filtration rate and renal parenchymal area in children with recurrent urinary tract infections and asymptomatic bacteriuria.

Adolescent↗
PubMed2006

Laparoscopic nephrectomy for giant staghorn calculus with non-functioning kidneys: is associated unsuspected urothelial carcinoma responsible for conversion? Report of 2 cases.

BACKGROUND: Neglected renal stones remain a major cause of morbidity in developing countries. They not only result in functional impairment of affected kidney, but also act as an important predisposing factor for development of urothelial neoplasms. It is not uncommon to miss an associated urothelial tumor in a patient of nephrolithiasis preoperatively. CASE PRESENTATION: In last 3 years, we came across two patients with giant staghorn calculus and poorly functioning kidneys who underwent laparoscopic nephrectomy. In view of significant perirenal adhesions & loss of normal tissue planes both these patients were electively converted to open surgery. The pathological examination of specimen revealed an unsuspected urothelial carcinoma in both these patients. The summary of our cases and review of literature is presented. CONCLUSION: It is important to keep a differential diagnosis of associated urothelial malignancy in mind in patient presenting with long standing renal calculi. The exact role of a computerized tomography and cytology in preoperative workup for detection of possible associated malignancy in such condition is yet to be defined. Similarly if laparoscopic dissection appears difficult during nephrectomy for a renal calculus with non-functional kidney, keeping a possibility of associated urothelial malignancy in mind it is advisable to dissect in a plane outside gerotas fascia as for radical nephrectomy.

Carcinoma, Transitional Cell↗
PubMedDate not supplied

Rapid clinical assessment of kidney function based on arm muscle circumference and serum creatinine.

A midarm muscle circumference (AMC) < 10th percentile indicates severe protein-energy malnutrition. We identified 20 consecutive patients receiving specialized nutritional therapy from the Nutrition Support Service of the New England Deaconess Hospital during a 3-mo period who had AMC < 10th percentile and 24-h urine and serum creatinine determinations performed. Mean weight was 96 +/- 25% of ideal body weight (IBW), with only 7 patients < 85% IBW, reaffirming that weight is often insensitive for the identification of lean tissue loss. Twenty-four-hour urine creatinine excretion confirmed most to be severely lean body mass depleted (creatinine-height index < 60% in 17 subjects) as predicted by AMC. Sixteen patients had normal kidney function as assessed by serum creatinine levels and hospital norms (0.3-1.2 mg/dl). However, abnormal creatinine clearances were found in 15 of 20 subjects (normal 80-100 ml/min), with a mean value (53 +/- 23 ml/min) also below normal. These results suggest that the usual normal range for serum creatinine, based on well-nourished patients, should be adjusted in severely malnourished patients. Considering the upper limit of normal serum creatinine in this population to be 0.7 mg/dl, to reflect the approximately 60% reduction in lean tissue indicated by an AMC < or = 10th percentile, would identify all but 1 patient with an abnormal creatinine clearance (sensitivity 93%, specificity 67%). Use of a predictive formula (the Cockcroft-Gault equation) also identified those with kidney dysfunction but overestimated actual function to a level not usually requiring drug dose adjustment and did not obviate the need for further testing.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

Acute effects of a somatostatin analogue on kidney function in type 1 diabetic patients.

Suppression of growth hormone by means of somatostatin has been suggested as a possible adjunct therapy in Type 1 diabetes. To assess the acute effect of the somatostatin analogue SMS 201-995 on kidney function in uncomplicated Type 1 diabetes, 13 normoalbuminuric, normotensive diabetic patients were investigated before and during IV infusion of SMS 201-995 (8 micrograms h-1). A control experiment with infusion of carrier only was also performed. The SMS infusion induced a reduction in the glomerular filtration rate (clearance of 125I-iothalamate) and renal plasma flow (131I-hippuran) from 140 +/- 15 (mean +/- SD) and 550 +/- 69 to 131 +/- 14 (2p less than 0.005) and 492 +/- 73 ml min-1 1.73-m-2 (2p less than 0.001), while filtration fraction and total renal resistance rose (both 2p less than 0.001). Urinary albumin excretion rate, blood pressure, and blood glucose concentration were unchanged. Plasma growth hormone and glucagon were significantly suppressed. The reduction in glomerular filtration rate and renal plasma flow correlated with the fall in glucagon concentration (r = 0.57, 2p = 0.04, and r = 0.63, 2p = 0.02). The urinary flow rate was markedly reduced, urine osmolality increased, and fractional excretion of sodium, calcium, and phosphate were reduced. Arginine vasopressin, atrial natriuretic peptide, angiotensin II, and aldosterone were unchanged by the SMS infusion. Thus SMS 201-995 acutely reduces glomerular filtration rate and renal plasma flow in uncomplicated Type 1 diabetes and has an antidiuretic effect. The effects may be related to suppression of glucagon secretion.

Adult↗
PubMed1990

Influence of hydration on ultrafilterable platinum kinetics and kidney function in patients treated with cis-diamminedichloroplatinum(II).

It has been reported that hypertonic saline provides protection against the renal toxicity of cisplatin (CDDP). We therefore evaluated its influence on the plasma and urinary pharmacokinetics of ultrafilterable platinum and kidney function as estimated by creatinine, inulin and PAH clearance. We undertook a randomized trial including two groups of ten patients receiving 100 mg/m2 CDDP in isotonic (group 1) or hypertonic saline (group 2) by a 20-min infusion. The hydration consisted of dextrose in group 1 and isotonic saline in group 2. Maximal concentration (Cmax), protein binding and cumulative urinary excretion were significantly higher in the dextrose group. Urinary flow decreased in this group but not in the other one. Inulin clearance was higher in the dextrose group than in the saline group and P-aminohippuric acid (PAH) clearance was not significantly different in these groups of patients. Hyponatremia was observed in the dextrose group. These results suggest that hypertonic saline infusion and saline hydration may enhance the diffusion of CDDP into tissues, lowering Cmax and renal excretion of platinum. The reduction of protein binding may indicate a diminution of aquation of CDDP in plasma. Our results suggest that the infusion of CDDP in hypertonic saline with salt hydration could exert a protective effect on the kidney. Moreover, there is a lessening of the risk of cellular hyperhydration. However, the better influence of dextrose hydration on glomerular filtration leads us to recommend a combination of the two methods of hydration for better tolerance and efficacy.

Chlorides↗
PubMed1981

Kidney function and histopathological changes in unilateral hydronephrosis with special reference to bilharzial ureter.

Fifty-six patients with unilateral hydronephrosis were the subject of this study. The patients were classified into 4 groups according to the stage of hydronephrosis as assessed by radiological criteria. Split kidney function, histopathological studies, and measurement of intraureteral pressure were performed. Urinary Bilharziasis was held responsible for obstructive nephropathy in 77% of cases. Complicating urinary infection was present in 66%. The study has shown that creatinine excretion was slightly decreased in early, moderate, and moderately advanced hydronephrosis. On the other hand, a marked lowering of urine osmolality was found even in the early stages of hydronephrosis. The hydronephrotic kidney was found to be a salt losing one only in early, moderate, and moderately advanced hydronephroses, but not in the very advanced cases. The histopathological changes were mainly tubular, but some cases showed proliferative changes in the glomeruli. Eradication of urinary Bilharziasis and early treatment of this disease would markedly contribute to the prevention of obstructive nephropathies in countries where this disease is endemic.

Adult↗
PubMed1998

Abnormal kidney function as a cause and a consequence of obesity hypertension.

1. Obesity is the most common nutritional disorder in the US and is a major cause of human essential hypertension. Although the precise mechanisms by which obesity raises blood pressure (BP) are not fully understood, there is clear evidence that abnormal kidney function plays a key role in obesity hypertension. 2. Obesity increases tubular reabsorption and this shifts pressure natriuresis towards higher BP. The increased tubular reabsorption is not directly related to hyperinsulinaemia, but is closely linked to activation of the sympathetic and renin-angiotensin systems, and possible changes in intrarenal physical forces caused by medullary compression due to accumulation of adipose tissue around the kidney and increased extracellular matrix within the kidney. 3. Obesity is also associated with marked renal vasodilation and increased glomerular filtration rate, which are compensatory responses that help overcome the increased tubular reabsorption and maintain sodium balance. However, chronic renal vasodilation causes increased hydrostatic pressure and wall stress in the glomeruli which, along with increased lipids and glucose intolerance, may cause glomerulosclerosis and loss of nephron function in obese subjects. Because obesity is a primary cause of essential hypertension as well as type II diabetes, there is good reason to believe that obesity may also be the most frequent cause of end-stage renal disease. 4. Future research is needed to determine the mechanisms by which excess weight gain activates the neurohumoral systems and alters renal structure and function. Because of the high prevalence of obesity in most industrialized countries, unravelling these mechanisms will likely provide a better understanding of the pathophysiology of human essential hypertension and chronic renal failure.

Animals↗
PubMed1976

The effect of indomethacin on kidney function and plasma renin activity in man.

125Iothalamate and 131I-hippuran clearances, sodium excretion and plasma renin activity (PRA) before and during indomethacin administration in an oral dose of 3 x 50 mg/day were studied in volunteers with a normal or reduced kidney function, as well on non-sodium-restricted as on sodium-restricted diet. Indomethacin induced a temporary sodium and water retention and a decrease in glomerular filtration rate. It also lowered PRA. The latter phenomenon did not depend on sodium retention and was present within 2 h after an oral dose of 50 mg. The results may be explained by indomethacin-induced inhibition of prostaglandin synthesis.

Glomerular Filtration Rate↗