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PubMed1995

[Kidney function in pregnant women with arterial hypertension].

In a group of 80 women in their 3rd trimester of pregnancy (29-36 weeks) 50 of whom were with hypertension and 30 healthy, the blood serum was studied for concentrations of urea, uric acid, creatinine, total proteins and electrolytes: sodium and potassium. The results were calculated statistically. In the serum of women with hypertension increased concentrations of urea and uric acid were found. Total protein concentration was lower in the studied group, especially those with primary arterial hypertension. Whereas concentration values of electrolytes Na+ and K+ did not seem to be affected by hypertension.

Adult↗
PubMed2001

Simultaneous blockade of endothelin A and B receptors in ischemic acute renal failure is detrimental to long-term kidney function.

BACKGROUND: There is growing evidence of long-term pathological consequences following renal ischemia. Endothelin (ET) receptor antagonists have proved beneficial in the treatment of ischemic acute renal failure (IARF); however, the long-term outcomes have not been assessed in this disease. METHODS: Experimental IARF was induced in uninephrectomized female Sprague-Dawley rats (N = 8) by clamping of the renal pedicle. At 24-hours postischemia, a once-only administration of drug or vehicle was given. One ischemic group received saline only (saline ischemic), and two other ischemic groups received either SB 234551 (ETA receptor antagonist, ETA group) or SB 209670 (ETA and ETB receptor antagonist, ETA/ETB group). A uninephrectomized control group was sham operated to simulate operative conditions without ischemia and was given a once-only saline infusion (sham ischemic). All groups were sacrificed at six-months postischemia. Serum creatinine was assessed daily for one week and then every four weeks. Glomerular filtration rates (GFRs), systolic blood pressure, 24-hour urine collection, and creatinine clearance were performed just prior to sacrifice. Immunohistochemistry for monocytes and macrophages (Mo and Mphi), myofibroblasts (MF, alpha-SMA), collagen IV, and collagen III was also evaluated. Cell kinetics were studied by immunostaining for proliferating cell nuclear antigen (PCNA) and by TUNEL. RESULTS: Urinalysis revealed significant increases in urinary protein and albumin in the ETA/ETB group when compared with all other groups. GFRs and creatinine clearance were also decreased significantly in the ETA/ETB group. Urine albumin, protein, GFR, and creatinine clearance in the ETA group, however, were not different from the sham ischemic and saline ischemic groups. Systolic blood pressure was increased in the saline ischemic group as compared with all other groups. Kidney weights were increased in all ischemic groups, but no differences were observed between the saline ischemic group and ETR antagonist-treated groups. Immunohistochemistry revealed relationships between Mo and Mphi, MF, and tubulointerstitial collagen III, where the saline ischemic and ETA/ETB groups were increased as compared with the sham ischemic and ETA groups. There was no change observed in tubulointerstitial collagen IV accumulation. The largest number of proliferating cells was demonstrated in the ETA/ETB group, whereas apoptotic cells were identified in small amounts in all groups, with the largest number being found in the saline ischemic group. CONCLUSIONS: Renal ischemia appears to have long-term functional and pathological consequences that can be prevented by treatment with ETA receptor antagonists. Blockade of both ETA and ETB receptors, however, appears to be detrimental to long-term kidney function.

Acute Kidney Injury↗
PubMed1989

Which routine test for kidney function?

Eighty measurements of plasma creatinine concentration, height:creatinine ratio, and plasma beta 2 microglobulin concentration were made on 72 children (age 4 months-18.5 years) with known renal disease. Results were compared with simultaneous measurements of glomerular filtration rate using plasma clearance of 51Cr edetic acid to assess the performance of each test as an initial screening procedure of renal insufficiency. Height:creatinine index less than 2.1 was found to have a higher sensitivity and predictive value of a normal result than the other tests and is therefore the preferred test for a screening procedure.

Adolescent↗
PubMed1994

[Determination of kidney function in patients with ovarian cancer treated with chemotherapy: calculation versus measurement of creatine clearance].

In patients with ovarian cancer receiving chemotherapy we compared the creatinine clearance measured in the usual way with the calculation of the creatinine clearance according to the formulas of Jelliffe and Cockroft. Regression analysis only showed a moderate correlation, whereas the analysis of the data by ROC curves allows the use of these formulas as screening tests with acceptable values of sensitivity and false-positive rate. Therefore, in the majority of these patients, collecting urine over 24 h before starting chemotherapy is no longer necessary.

Adult↗
PubMed1988

[Acute oral protein administration in the diagnosis of kidney function and causal pathogenetic correlations].

In a literature review it was reported on the performance-orientated diagnostic determination of the glomerular filtration rate by acute oral protein load in man. Recommendations to the standardization of the test realisation are presented. The results of the glomerular filtration reserve--being derived from acute intraindividual changes of the creatinine short-term clearance after an oral protein load--are described in dependence on the renal starting situation. The causal-pathogenetic relations are represented in consideration of the natriuretic hormone and of the pathophysiological model character of the GFR-provocation test to hormonal starting processes, respectively.

Creatinine↗
PubMed1994

[Kidney function in hypertensive patients with chronic renal failure treated with the dual eliminated ACE-inhibitor spirapril].

PATIENTS AND METHOD: Spirapril is a recent ACE inhibitor with a both renal and hepatic elimination pathway. In order to determine its tolerability, primarily the impact on renal function, Spirapril was tested in a single-blind trial with a 2-week placebo run-in phase and a 4-week active treatment period. Forty-nine patients (34 males and 15 females) with varying degrees of renal impairment were included. Their pretreatment diastolic blood pressure (DBP) ranged from 95 to 115 mm Hg. Spirapril was administered in oral doses of 6 mg once daily. RESULTS: Forty-four patients completed the study. Four patients dropped out due to side effects, 1 patient was withdrawn from the study due to lack of antihypertensive efficacy. 48% of the completers with renal failure achieved a normalized diastolic blood pressure (DBP < or = 90 mm Hg) or a reduction in DBP of > or = 10 mm Hg; the corresponding figure for patients with normal renal function was 31%. Renal function was assessed in the beginning and at the end of the active Spirapril treatment period using Tc-99m-DTPA-clearance (representing glomerular filtration rate), J-131-hippuran-clearance (representing renal plasma flow) and creatinine clearance. Particularly in patients with renal impairment, Spirapril did not deteriorate renal function as given by these parameters. Regression analysis revealed a linear correlation between total plasma clearance of the active metabolite Spiraprilate and creatinine clearance. There was no evidence for drug accumulation. CONCLUSION: In patients with renal impairment the pharmacokinetic results indicate a non-renal elimination of the drug. Spirapril 6 mg once daily is concluded to be a well tolerated antihypertensive therapy for patients with mild to moderate hypertension and varying degrees of chronic renal failure.

Administration, Oral↗
PubMed1997

A study of ethylene glycol exposure and kidney function of aircraft de-icing workers.

Ethylene glycol levels were measured in 154 breathing zone air samples and in 117 urine samples of 33 aviation workers exposed to de-icing fluid (basket operators, de-icing truck drivers, leads and coordinators) studied during 42 worker-days over a winter period of 2 months at a Montreal airport. Ethylene glycol as vapour did not exceed 22 mg/m3 (mean duration of samples 50 min). Mist was quantified at higher levels in 3 samples concerning 1 coordinator and 2 basket operators (76-190 mg/m3, 45-118 min). In 16 cases workers' post-shift or next-morning urine contained quantities of ethylene glycol exceeding 5 mmol/mol creatinine (up to 129 mmol/mol creatinine), with most of these instances occurring in basket operators and coordinators, some of whom did not wear paper masks and/or were accidentally sprayed with de-icing fluid. Diethylene glycol was also found in a few air and urinary samples at levels around one tenth those of ethylene glycol. Urinary concentrations of albumin, beta-N-acetyl-glucosaminidase, beta-2-microglobulin and retinol-binding protein were measured and compared over various periods, according to subgroups based on exposure level and according to the frequency of extreme values. These analyses did not demonstrate acute or chronic kidney damage that could be attributed to working in the presence of ethylene glycol. In conclusion, this study does not suggest important health effects of exposure to de-icing fluid in this group of workers. Potential for overexposure exists, however, in certain work situations, and recommendations on preventive measures are given. In addition, these results suggest that other routes of absorption than inhalation, such as the percutaneous route, may be important and that urinary ethylene glycol may be a useful indicator of exposure to ethylene glycol.

Acetylglucosaminidase↗
PubMed1991

[Effect of somatostatin on kidney function].

The renal effect of cyclic somatostatin was studied on healthy subjects. The somatostatin was used at therapeutical dose in intravenous infusion. Somatostatin decreases the renal plasma flow, glomerular filtration rate, osmotic and free water clearances, sodium and potassium excretion and the tubular reabsorption of phosphorus while urinary osmolality increases. Under somatostatin infusion the urinary excretion of catecholamines, PGE2, PGF2 alfa and the plasma renin activity and the plasma concentration of glucagon and growth hormone decrease. The antidiuretic activity of somatostatin is due to a) a direct haemodinamic effect, b) an influence on the renal tubular transport as well and also c) because of change the water handling in the collecting ducts.

Adult↗
PubMedDate not supplied

Effects of thyroid hormones on heart and kidney functions.

Thyroid hormones affect the functions of several organs including the heart and kidney. Using isolated left papillary muscles we have investigated the action of thyroid hormones on the mechanical and electrical properties of the heart. We found that pure hypothyroidism causes a depression in contractile and electrical parameters, but we noticed that superimposed hypoparathyroidism accounts for the marked prolongation in contractile kinetics and action potential duration. At kidney level we have shown that thyroid hormones affect proximal tubular sodium transport and this effect is only partially mediated by the action of thyroid hormones on Na-K-ATPase activity. Using the micropuncture technique, we hypothesized that the early effect of thyroid hormone action is on the potassium permeability of proximal tubular cell membrane. This latter effect would explain the increase in isotonic fluid reabsorption through an increase in the driving force for sodium. Finally, hypothyroid patients have a decrease in glomerular filtration rate and renal plasma flow that are completely reversed by thyroxine administration. On the other hand, hyperthyroid subjects exhibit a significant increase in both parameters.

Animals↗
PubMed1984

[Serum levels and urine excretion of L-carnitine in patients with normal and impaired kidney function].

The influence of age, sex, and renal function on serum levels and urinary excretion of free carnitine was studied in 187 subjects. Sixty-one subjects with normal renal function (creatinine clearance greater than 100 ml/min) showed a serum carnitine level of 72.2 +/- 23.2 mumol/l. The carnitine values of males (76.8 +/- 23.3 mumol/l, n = 39) were higher (p less than 0.05) than those of females (64.0 +/- 21.0 mumol/l, n = 22). Carnitine levels did not correlate with age. Values in patients with normal renal function did not differ from serum carnitine levels in healthy controls (74.7 +/- 17.5 mumol/l, n = 49). The mean urinary carnitine excretion per day was 163.5 mumol (range 63.7-419.6 mumol) in patients with intact renal function. Extreme impairment of glomerular filtration rate (creatinine clearance less than 20 ml/min) resulted in higher carnitine concentrations in serum (108.9 +/- 39.4 mumol/l, n = 18, p less than 0.05), lower carnitine elimination per day (78.5 mumol, range 14.5 - 424.3 mumol, n = 18, p less than 0.05) and a decreased carnitine clearance (0.8 ml/min, range 0.2 - 3.8 ml/min). These data together with earlier results obtained in dialysis patients suggest that carnitine metabolism in renal failure is altered by reduction of both endogenous carnitine biosynthesis and renal carnitine clearance.

Adolescent↗
PubMed1991

Effect of somatostatin on kidney function and vasoactive hormone systems in health subjects.

The acute effects of i.v. somatostatin (250 mcg bolus followed by 250 mcg/h continuous infusion for two hours) on renal hemodynamics, renal electrolyte and water handling, and urinary excretion of catecholamines and prostaglandins, as well as on plasma concentrations of arginine vasopressin, atrial natriuretic factor, norepinephrine, epinephrine, dopamine, glucagon, and plasma renin activity were studied in seven normal subjects. Somatostatin decreased effective renal plasma flow and glomerular filtration rate, osmotic and free water clearances, urine volume, and sodium and potassium excretion, while urinary osmolality, fractional excretion of sodium, and phosphate excretion increased significantly. Plasma concentrations of arginine vasopressin, atrial natriuretic factor, norepinephrine, epinephrine, and dopamine remained unchanged, while plasma renin activity (3.0 +/- 0.25 vs 2.4 +/- 0.2 ng AngI/ml/h; p less than 0.01) and glucagon levels (40 +/- 11 vs 20 +/- 16 pg/ml; p less than 0.01) decreased. Urinary excretion of norepinephrine, epinephrine, dopamine, PGE2, and PGF2 alpha was suppressed under somatostatin. A significant positive correlation was found between urinary dopamine and sodium excretion (r = 0.7; p less than 0.001) and urinary prostaglandin E2 and glomerular filtration (r = 0.52; p less than 0.01). Without accompanying changes in plasma osmolality and vasopressin concentration significant antidiuresis occurred, suggesting a direct tubular effect of somatostatin. However, the hormone-induced changes are due mainly to the decrease in renal plasma flow. The results demonstrate that somatostatin at supraphysiological doses exerts significant effects on the kidney.

Adult↗
PubMed1975

[The simultaneous investigation of liver and kidney function in the presence of dopamine (author's transl)].

The effect of dopamine on liver function and on renal blood flow and the glomerular filtration rate was studied in 13 patients suffering from liver cirrhosis. Hence, the BSP retention and 131I BSP clearance was determined and also the clearance of 99mTc DTPA and of 125I hippuran in decreasing concentrations, as well as under steady state conditions. Methodological problems arising from the application of the slope clearance technique in cirrhotic patients are discussed. Dopamine did not affect the BSP clearance and BSP retention, but a significant increase in renal plasma flow was observed. The glomerular filtration rate was not significant altered.

Adult↗
PubMedDate not supplied

[Disorders of kidney function in patients with benign prostatic hyperplasia].

The examination of 648 males aged 50 to 86 to conduct an early outpatient detection of renal dysfunction in the elderly men employed an original technique of renal function assessment based on the kinetics of urinary 5-NOK elimination. Renal dysfunctions were revealed in 165 patients, in 159 of them the underlying cause was benign prostatic hyperplasia. The results were compared with those obtained at radionuclide tracing and Reberg-Tareev test. The correlation found indicated the authors' technique informative value and its compatibility with the above methods. Identification of renal dysfunction at early stages of benign prostatic hyperplasia allowed their timely hospitalization and operative treatment which enables the physicians to prevent progression of chronic renal failure in these patients.

Aged↗
PubMed1991

[Effect of the ACE-inhibitor captopril on the blood pressure and kidney function of patients with essential and renal hypertension].

We retrospectively analysed the effects of a 12-month treatment with captopril (Tensiomin) in 46 patients. All of the patients had hypertension lasting for years (9 essential, 37 with chronic renal failure), 32 of them had proteinuria. Captopril was given in addition to, or in exchange for, other antihypertensive drugs. Under treatment with ACE-inhibitors, a small but significant decrease in diastolic blood pressure (0.4 torr/month) and in proteinuria (0.19 g/month) was seen (regression analysis). Discriminant analysis showed proteinuria and diastolic blood pressure to be the more modifiable, the younger the patients, the higher the proteinuria at the beginning and the longer the history of hypertension. Serum creatinine, blood urea nitrogen, serum protein and serum potassium did not change.

Adult↗
PubMed1986

[Kidney function, blood pressure and weight behavior in long-term diabetic patients].

All long-term diabetics (1,108 cases) of the district Neubrandenburg were investigated in a cross-section study and compared with a non-diabetic population. Long-term diabetics were significantly more frequently suffering from renal insufficiency (44.9%) and hypertension (54.7%) but they were more rarely obese than nondiabetics. A clearly positive correlation existed in the two groups between hypertension and renal insufficiency as well as between obesity and hypertension. With growing age the proportion of long-term diabetics suffering from renal insufficiency and hypertension increased. The treatment of hypertension must be regarded as highly important in the care of diabetics.

Adolescent↗
PubMed1958

A comparison of some activities of arginine vasopressin and lysine vasopressin on kidney function in conscious dogs.

Comparison was made on conscious trained dogs of the effect of highly purified arginine vasopressin and lysine vasopressin on the rate of urine flow, the excretion rate of Na and K and the renal clearances of creatinine and diodone, and of the actions of the vasopressins when administered together with oxytocin. The vasopressins were used in doses causing a maximal antidiuresis.The results showed, first, that the antidiuretic potency of arginine vasopressin was greater than that of lysine vasopressin and that its action lasted longer; second, that during water diuresis arginine vasopressin increased only Na excretion while lysine vasopressin increased both Na and K excretion; third, that arginine vasopressin had a potency about 5 to 6 times that of lysine vasopressin in antagonizing the augmentor effect of oxytocin on glomerular filtration rate and renal plasma flow.

Animals↗
PubMed1989

[Assessment of kidney function before cisplatin administration: the need for 24-hour urine collection].

Creatinine clearance as a measure of the glomerular filtration rate is calculated from the serum creatinine, urine creatinine concentration and the 24-h urine volume (MCC). Cockroft and Gault as well as Davila and Gardener have shown that estimation of the creatinine clearance (ECC) from the serum creatinine, age, sex, and weight of the patient is at least as accurate as measurement of creatinine clearance (MCC). ECC is not influenced by inaccurate collections of urine or incorrect analyses of urine creatinine. 125 MCC was investigated in 51 patients receiving cisplatin. If ECC is less than or equal to 80, then MCC should eliminate inaccurate urine collections. If the value of ECC exceeds 80, it is not necessary to measure MCC.

Circadian Rhythm↗