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PubMed1999

Individual kidney function in atherosclerotic nephropathy is not related to the presence of renal artery stenosis.

BACKGROUND: Atherosclerotic renovascular disease is increasingly recognized as an important cause of renal failure in patients over 60 years of age but the processes leading to renal dysfunction have not been defined. We have examined the relationship between renal artery stenosis and individual renal function in patients with atherosclerotic renal artery stenosis. METHODS: In this prospective descriptive study over a 25-month period, we examined the relationship between the presence of renal artery stenosis and single kidney glomerular filtration rate (SKGFR). SKGFR was measured using a novel method of synchronous (51)Chromium ethylenediamine tetraacetic acid glomerular filtration rate ((51)CrEDTA-GFR) and (99m)Technetium dimercaptosuccinic acid ((99m)TcDMSA) scintigraphy. We studied 79 patients with a mean age of 68.9 years (25.2-88.2), 44 males and 35 females. The mean age of the males was 70 years (60-80) and females 67 years (25.2-88.2). RESULTS: We found that the precision of the SKGFR was 2 ml/min. For paired kidneys we found: (i) no significant difference between kidneys with stenosis (17.3 ml/min) compared to those without stenosis (13.6 ml/min) (P=0.22); (ii) kidneys with occluded renal arteries had significantly less function (2.6 ml/min) than those without occlusion (24.5 ml/min) (P<0.05). When degree of renal arteries stenosis was correlated with SKGFR there was a reduction with an increasing degree of stenosis (<30% 27 ml/min, 30-60% 17.7 ml/min, >60% stenosis 15 ml/min, P=0. 016). CONCLUSIONS: These data demonstrate that SKGFR provides a reproducible measure of individual kidney function. There was a similar impairment of function in paired kidneys with and without renal artery stenosis, but occlusion was associated with significant reduction in function compared to the contralateral kidney. This suggests that there is a process causing renal dysfunction in patients with atherosclerotic disease independent of renal artery narrowing.

Adult↗
PubMed1979

Excretion patterns of alkylating metabolites in urine following cyclophosphamide treatment of tumor patients: influence of application route, dosage, liver and kidney function.

The excretion patterns of cyclophosphamide (CP) in urine were studied in 54 tumor patients aged between 21 and 61 years, using the nitrobenzyl-pyridine (NBP) reaction, with regard to the route of application (i.v., i.m. or oral), the CP dose and the functional state of the liver and kidney. The studies were carried out in nephrectomized patients and patients with liver affections caused by the basic disease, in particular with malignant lymphomas and mammary carcinomas. The following results were obtained: 1. There exists a direct relationship between the dose of CP applied and the quantitative excretion of alkylating metabolites in urine. According to these studies in which the patients received up to 2.8 g CP/m2 body surface, the upper CP dose was limited by the generally toxic side effects rather than by the metabolization rate. 2. At comparable CP doses the route of application (i.v., i.m. or oral) has no appreciable influence on the excreted NBP activity. 3. Disorders of the liver function without signs of icterus are not a contraindication to CP treatment. 4. The functional failure of one kidney has no statistically significant influence on the excretion of alkylating metabolites in urine.

Administration, Oral↗
PubMed1975

A scintillation camera technique for quantitative estimation of separate kidney function and its use before nephrectomy.

A scintillation camera technique was used for measuring renal uptake of [131I]Hippuran 80-110 s after injection. Externally measured Hippuran uptake was markedly influenced by kidney depth, which was measured by lateral-view image after injection of [99mTc]iron ascorbic acid complex or [197Hg]chlormerodrine. When one kidney was nearer to the dorsal surface of the body than the other, it was necessary to correct the externally measured Hippuran uptake for kidney depth to obtain reliable information on the true partition of Hippuran between the two kidneys. In some patients the glomerular filtration rate (GFR) was measured before and after nephrectomy. Measured postoperative GFR was compared with preoperatively predicted GFR, which was calculated by multiplying the preoperative Hippuran uptake of the kidney to be left in situ, as a fraction of the preoperative Hippuran uptake of both kidneys, by the measured preoperative GFR. The measured postoperative GFR was usually moderately higher than the preoperatively predicted GFR. The difference could be explained by a postoperative compensatory increase in function of the remaining kidney. Thus, the present method offers a possibility of estimating separate kidney function without arterial or ureteric catheterization.

Adult↗