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PubMed1989

[Radionuclide examination of kidney function in children with vesico-renal reflux].

The authors report on their experience with the assessment of radionuclide, separated renal clearance in children with unilateral vesicorenal reflux. The radiopharmaceutical preparation 131I-orthoiodohippuran was used, the result of the examination was a separated effective renal plasma flow (ERPF) which was assessed according to a modification of Oberhausen's method. A total of 28 children were examined. In 8 children the vesicorenal reflux was grade III and IV, in 20 children a unilateral grade II vesiculorenal reflux was involved. In both groups the authors demonstrated a significant functional deficit (p less than 0.001) of the kidney with the reflux despite the fact that in the second group all children had normal excretory urography, a negative urinary sediment and a normal creatinine and urea blood level.

Child↗
PubMed1994

[The effect of blood pressure-lowering treatment of essential hypertension on kidney vasculature and kidney function].

The tight embrace between blood pressure control and renal function makes it extremely difficult, particularly in the case of essential hypertension, to disentangle the reciprocity of cause and effect relationships. Even ingenious models of experimental hypertension have failed to provide a firm answer as to the order of sequence between these two entities. While not excluding the possibility of a subtle renal defect as a prime mover in essential hypertension, we have preliminarily adopted the thesis that hypertension per se is the main condition, which subsequently induces functional changes in the kidney. The latter may then contribute in their turn to the persistence or even the progression of the hypertensive process. The earliest detectable change in the hypertensive kidney is an apparent vasoconstriction. Since glomerular filtration rate appears to be maintained in the face of this, efferent arteriolar tone is likely to be enhanced. Using pharmacological tools we have been able to establish that local pressor systems are responsible for the above vasoconstriction: both alpha-2 receptors and the renin-angiotensin system appear to be involved. From a preventive point of view it might make sense to use antihypertensive drugs in order to abolish the renal vasoconstriction: this way the involvement into structural arteriolar changes could perhaps be prevented. Although indeed currently used antihypertensive drugs facilitate renal blood flow, their ultimate role in salvaging the kidney remains to be established.

Antihypertensive Agents↗
PubMed2006

Can the kidney function as a lung? Systemic oxygenation and renal preservation during retrograde perfusion of the ischaemic kidney in rabbits.

OBJECTIVE: To investigate renal preservation by a novel method of perfusion using an oxygenated perfluorocarbon (PFC) emulsion via retrograde access to the kidney, as preserving renal function during urological surgery has been elusive, and the recognized technique of nephron-sparing surgery has increased its application and practice in modern urology. MATERIALS AND METHODS: After institutional review and approval, 30 New Zealand White rabbits were studied. In a solitary kidney model, each rabbit had the ureter catheterized before 40 min of renal artery occlusion. Each rabbit was randomized to one retrograde perfusion group, i.e. sham, normothermic PFC, chilled PFC, normothermic saline, and chilled saline. The rabbits were maintained for 2 weeks, during which renal function, urine output, systemic blood gases, weight and serum creatinine level were measured. After death, the kidneys were individually examined and graded by one renal pathologist unaware of the treatment. RESULTS: The rabbits treated with retrograde PFC perfusion (normothermic and chilled) had less change in their creatinine clearance, at 3.6 and 4.0 mL/min per kg, than the sham group, at 7.8 mL/min per kg, while also having significantly higher systemic venous oxygenation, at 26.3 and 10.0 mmHg, than the sham group, at 0.2 mmHg. Normothermic and chilled perfusion with PFC was also associated with less histological evidence of ischaemic damage, with mean (sd) scores of 13.0 (13.5) and 8.7 (4.5), respectively, than in the sham group, at 33.3 (16.8), while favourably matching the contralateral control kidney group, at 5.5 (2.3). The rabbits treated with saline retrograde perfusion also had better outcomes than the sham cohort. There were no adverse effects in any of the study arms or with the use of PFC. CONCLUSION: Retrograde oxygen delivery to the kidney through the urinary collecting system was successful in this pilot study. Renal function, laboratory and histological data indicate a trend towards renal preservation and even systemic oxygenation in the experimental groups compared with the sham rabbits, with no adverse effects attributed to this technique.

Animals↗