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At least 1,081 records · Page 60Linked to original sources
PubMed2004

Using serum creatinine to estimate glomerular filtration rate: accuracy in good health and in chronic kidney disease.

BACKGROUND: The National Kidney Foundation has advocated the use of the abbreviated Modification of Diet in Renal Disease (MDRD) equation to estimate glomerular filtration rate (GFR) from serum creatinine measurements in clinical laboratories. However, healthy persons were not included in the development of the MDRD equation. OBJECTIVES: To assess the accuracy of the MDRD equation in patients with chronic kidney disease compared with healthy persons and to develop a new equation that uses both patients with chronic kidney disease and healthy persons. DESIGN: Cross-sectional study. SETTING: The Mayo Clinic, a tertiary-care medical center. PARTICIPANTS: Consecutive patients (n = 320) who had an iothalamate clearance test specifically for chronic kidney disease evaluation and consecutive healthy persons (n = 580) who had an iothalamate clearance test specifically for kidney donor evaluation. MEASUREMENTS: Serum creatinine levels, GFR, demographic characteristics, and clinical characteristics were abstracted from the medical record. RESULTS: The MDRD equation underestimated GFR by 6.2% in patients with chronic kidney disease and by 29% in healthy persons. Re-estimated coefficients for serum creatinine and sex were similar to the original MDRD equation in the chronic kidney disease series but not in the healthy series. At the same serum creatinine level, age, and sex, GFR was on average 26% higher in healthy persons than in patients with chronic kidney disease (P < 0.001). A quadratic GFR equation was developed to estimate logarithmic GFR from the following covariates: 1/SCr, 1/SCr2, age, and sex (where SCr = serum creatinine). LIMITATIONS: The new equation was not developed in a general population sample. Elderly and African-American persons were underrepresented. CONCLUSION: The MDRD equation systematically underestimates GFR in healthy persons. A new equation developed with patients who have chronic kidney disease and healthy persons may be a step toward accurately estimating GFR when the diagnosis of chronic kidney disease is unknown.

Adolescent↗
PubMedDate not supplied

Effects of renal impairment on the disposition of orally administered enalapril, benazepril, and their active metabolites.

The pharmacokinetics of benazepril, enalapril, and their active metabolites (benazeprilat and enalaprilat) were compared after a single administration of each product by the oral route at the recommended dosage (0.5 mg/kg for both drugs) in the dog before and after moderate experimental renal impairment. Ten dogs were randomly assigned to 2 groups of 5 animals in a 2-period crossover design for angiotensin-converting enzyme inhibitor administration. Renal failure was surgically induced by right nephrectomy and electrocoagulation of the remaining kidney. Renal mass reduction induced a significant decrease (P < .001) in glomerular filtration rate (GFR) (1.7 +/- 0.3 versus 3.3 +/- 0.7 mL/kg/minute). No significant differences before and after surgery were observed for enalapril and benazepril kinetics. The area under the curve (AUC) for enalaprilat increased after surgery from 23.6 +/- 14.7 to 42.4 +/- 20.9 micrograms.minute/mL (P < .01). Mean peak plasma concentration (Cmax) was increased in the impaired dogs (59.1 +/- 23.3 versus 43.9 +/- 32.9 ng/mL), but this variation was not significant (P > .05). Renal failure had no significant effect on AUC for benazeprilat (13.8 +/- 9.8 versus 14.9 +/- 5.0 micrograms.minute/mL) (P > .05), but Cmax decreased significantly (from 55.0 +/- 26.4 to 31.9 +/- 17.7 ng/mL) (P < .05). Multiple regression analysis showed that both GFR and AUC for enalapril were highly significant variables that explained the variation in AUC for enalaprilat (R2 = .86, P < .001) but not for benazeprilat (R2 = .12, P > .05). The results of this study indicate that exposure to enalaprilat, but not to benazeprilat, is increased in dogs with subclinical renal impairment.

Administration, Oral↗
PubMed1976

[Contrast media enhancement in cranial computed tomography --studies of iodinated contrast infusion (ICI)].

The effect of infusion of iodinated contrast material on the enhancement of the computed tomography were studied in several kinds of the intracranial lesions. Especially, relationship between the degree of the enhancement and the time interval after the infusion was examined. It was found that the appearance of the enhancement effect were different according to the pathological types of the lesions. There were also time differences even in the same lesion before the full size of the lesions was demonstrated. The pathological type of the lesions could be suggested from the enhanced figures of the lesions, but the diagnosis would be more accurate in consideration of the localization of the lesions. It was thus concluded that this method was useful for the detection of the precise localization and the size of the lesions which were not so clearly demonstrated in conventional cranial computed tomography.

Brain Diseases↗
PubMed1976

Thyroid function following intravenous pyelography.

Thyroid function was assessed by total serum thyroxine, free thyroxine index and serum triiodothyronine immediately prior to intravenous pyelography in 105 female outpatients. The thyroid function tests were repeated two months later. Although all three parameters showed a statistically significant mean rise, the changes were small and not clinically significant. Two patients from the study population with a past history of thyrotoxicosis had a transient elevation in serum triiodothyronine but neither patient developed clinical features of hyperthyroidism.

Adult↗
PubMed1975

[Ventriculography with methylglucamine iocarmate (Dimer-X). Experimental and Clinical study (author's transl)].

Evaluation of 60% solution of Methylglucamine iocarmate (Dimer-X) for ventriculography in animal experiment and clinical cases was reported. The experimental result was compared with that of Conray 60 and Angiografin, which was reported in our previous papers. In seven intraventricular injections of 2.0 ml, administered to 6 dogs, convulsion was observed on three occasions, facial myoclonus on 1 and no symptoms on the remaining three. However, in 7 intraventricular injections of 1.5 ml for 6 dogs, 6 were symptom-free and only residual one showed convulsion. And no dog died in either experiment. No changes were seen in a subsequent ventriculogram one month after the 1st ventriculography with Dimer-X and also no histological changes of the ventricular wall were revealed one month after the first experiment. These experimental results suggested less toxicity of Dimer-X than Conray 60 or Angiografin. Clinically, in 17 neurosurgical patients, ventriculography was performed with 1-5 ml of Dimer-X. No patients showed convulsive complication, but there was one episode of vomiting in each of 2 cases and slight headache in one case. From our experimental and clinical studies, it is concluded that the Dimer-X is to be considered the best watersoluble contrast medium for ventriculography at present.

Adolescent↗
PubMed1976

[Dimer-X ventriculography (author's transl)].

After the first report on ventriculography with a water-soluble contrast medium, Conray, by Campbell et al., many authors reported complications such as convulsion which are attributable to the irritating effect of this agent. On the other hand its value has been appriciated. Recently Gonsette recommended a new water-soluble contrast medium, meglumine iocarnate (Dimer-X), for ventriculography and reported that this new agent is less epileptogenic and less harmful. Because of these advantages, they have been performing ventriculography routinely with Dimer-X and recognized its usefulness. The only noticeable complication has been the transient elevation of body temperature in almost a half of the series. As far as our experience goes there is no case of convulsive seizure as complication. As compared to gas ventriculography, the fine details of dimension and configuration of the ventricles are far more beautifully delineated with the water-soluble contrast media.

Adult↗
PubMed1976

[Dimer-X in the intracranial subarachnoid space--its toxicity (author's transl)].

The reaction of the rats to injection of Dimer-X into the intracranial subarachnoid space or the cerebrum was examined. When 28% iodine Dimer-X was injected into the subarachnoid space, 7 of 10 rats showed agitation, which is the most severe complication, and all died within one hour. All of the reactions were reduced with the lower concentrations of Dimer-X. The rats which were premedicated with Valium and/or Decadron revealed fewer and less severe complications. It is believed that the intracerebral injection method has many disadvantages, the results of its experiment are therefore reported without further elaboration. From the results of the experiment it is concluded as follows: 1) Dimer-X should not be injected into the intracranial subarachnoid space. 2) Dimer-X of low concentration in the subarachnoid space reduces the complications. 3) Complications from the subarachnoid application of Dimer-X can be reduced by premedication with Valium and Decadron.

Animals↗
PubMed2000

Iodinated contrast media induced oxidative stress status in patients undergoing urography.

BACKGROUND: The present investigation is an extension of our earlier work on oxidative stress in a number of clinical situations and awareness of potential toxicity of contrast media. It was of interest to understand the relative safety (in terms of balance between oxidants/antioxidants) of the usage of iodinated contrast media in urography. METHODS: Alterations in serum levels of oxidant lipid peroxidation and product malondialdehyde (MDA) and components of anti-oxidant have been studied in 125 patients (with renal calculus disease) to undergo intravenous urographic procedure before and 3 hours following intravenous administration of Trivideo-400 (Iothalmate Sodium 40 ml: 18 gm Iodine) and results of serum levels of MDA (nmol/ml), SOD (mu/ml), Vit-C and Vit-E (mg/dl) were also compared with 135 appropriately age matched controls. RESULTS: The salient features of present investigation indicated definite pattern viz. Significant rise in serum levels of oxidant MDA (4.35 +/- 2.05) and fall in SOD (3.04 +/- 1.04), Vit-C (0.55 +/- 0.17), Vit-E (0.67 +/- 0.20) in patients at pre-IVU stage in comparison with those of controls viz MDA (4.35 +/- 2.05), SOD (3.77 +/- 1.55), Vit-C (0.71 +/- 0.25) and Vit-E (0.80 +/- 0.30). There occurred further elevation in serum levels of MDA (5.28 +/- 2.48) and fall in SOD (3.07 +/- 0.97), Vit-C (0.52 +/- 0.16), Vit-E (0.66 +/- 0.19) showing no significant alterations 3 hours following intravenous IVU procedure. CONCLUSIONS: It is concluded that contrast media induced changes did remain within tolerable physiological limits and no significant changes in anti-oxidant components Vit-E and SOD were suggestive of relative safety of iodinated contrast media usage.

Adolescent↗
PubMedDate not supplied

Improved techniques for lumbar aortography.

The use of a large volume technique (60-100 ml of contrast) for lumbar aortography is recommended for routine use in the investigation of peripheral arterial disease of the legs. With this method lesions are less likely to be missed and more information is obtained. Using the modern contrast media such as iothalamate, the complications due to contrast medium are not significantly greater than with the conventional volume technique. In Leriche syndrome, although the proximal end of the arterial occlusion can be demonstrated using conventional volume anortography, the distal end, and the arteries below the occlusion can usually only be shown by using a relatively large volume of contrast. Movement of a patient with a lumbar aortography needle in position is safe. Additional projections such as obliques to show the origins of the profunda femoris arteries or the arteries of the feet, can be taken if required. Complications due to stripping of the aortic wall are diminished if a blocked ended single side opening lumbar aortography needle is used.

Aortography↗