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PubMed1982

Radionuclide determination of individual kidney function in the treatment of chronic renal obstruction.

Differential radionuclide renal scans can be useful in the management of patients with chronic partial obstruction of 1 kidney. The 99mtechnetium diethylenetriaminepentaacetic acid perfusion scan can be used to assess glomerular blood flow. The 131iodine orthoiodohippurate renal scan provides qualitative functional information from scintigrams and quantitative evaluation of effective renal plasma flow to each kidney, as well as a total excretory index. Sequential 99mtechnetium diethylenetriaminepentaacetic acid and 131iodine orthoiodohippurate renal scans were used to assess individual renal function before and after surgical correction of unilateral chronic renal obstruction in 31 patients. The preservation of cortical perfusion on 99mtechnetium diethylenetriaminepentaacetic acid scans indicated that potential existed for partial recovery of renal function. Effective renal plasma flow and excretory index determined in conjunction with the 131iodine orthoiodohippurate scans provided a quantitative assessment of preoperative renal function, an evaluation of the effect of surgery and a sensitive method for long-term evaluation of differential renal function. Correction of ureteropelvic junction obstruction usually resulted in improvement in unilateral renal function. Neither nephrolithotomy nor extended pyelolithotomy diminished renal function in the kidney subjected to an operation and often improved it. Patients with long-standing distal ureteral obstruction had the least improvement in renal function postoperatively.

Adolescent↗
PubMed1994

[Therapy with ACE inhibitors in chronic heart failure and limited kidney function].

UNLABELLED: Renal function in 31 patients with mild to moderate heart failure (NYHA Classes II-III) was studied before and during treatment with ACE-inhibitors. Maximal treatment doses were based on randomization: captopril 3 x 12.5 mg or lisinopril or enalapril, both 1 x 10 mg. Before therapy and at the end of titration phase (after 6 days) glomerular filtration rate and renal blood flow were determined from inulin and PAH clearance (steady-state method). In the total study group the median arterial pressure significantly decreased from 94 mmHg to 84 mmHg (p < 0.01), whereas glomerular filtration rate was only moderately, however, significantly reduced from 103 ml/min to 97 ml/min (median values, p < 0.01). Renal blood flow, however, increased from 372 ml/min to 403 ml/min (p < 0.01). Changes in glomerular filtration rate (GFRd) were significantly dependent on those of renal blood flow (GFRd = 0.07 RPFd - 9.2; p < 0.05). All three ACE-inhibitors showed similar changes in glomerular filtration rate and renal blood flow. Ten of the patients had additionally received cyclooxygenase inhibitors. With respect to severity of heart failure and renal function these patients did not differ from the remaining 21 patients of the group. In both groups, a decrease of glomerular filtration rate was found, however, in those patients who had received acetylsalicylic acid there was no increase of renal blood flow. CONCLUSION: A small, however significant decrease of glomerular filtration rate is already seen in patients with mild to moderate heart failure treated with ACE-inhibitors. Increase of renal blood flow counteracts the decrease of glomerular filtration rate. During concomitant application of acetylsalicylic acid the increase of renal blood flow remains absent.

Aged↗
PubMed1987

[Kidney function and behavior of blood pressure in short-term diabetic patients. A follow-up study 1982-1986].

In 1982 there were increased creatinine values in 24.9 per cent (n = 344) of 1,380 investigated short-term diabetics of a closed territory. The course of disease of these 344 cases was followed in a follow-up-study. None of the patients had come to dialysis treatment. 32.3 per cent had died until 1986. In no case uremia caused the death. Hypertonias had a significant higher creatinine level than normotoniacs. The creatinine rise was on a higher level with the hypertoniacs. In 1982 the frequency of hypertension in the group of the died patients was with 65.8 per cent significant higher than in the group of the 1986 still living patients (32.9 per cent).

Adult↗
PubMed2005

Prevalence of decreased kidney function in Chinese adults aged 35 to 74 years.

BACKGROUND: Chronic kidney disease (CKD) is a major public health burden in Western countries but little is known about its impact in developing countries. We estimated the prevalence and absolute burden of CKD in the general adult population in China. METHODS: A cross-sectional survey was conducted in a nationally representative sample of 15,540 Chinese adults aged 35 to 74 years in 2000 and 2001. Serum creatinine was measured using the modified kinetic Jaffe reaction method at a central laboratory calibrated to the Cleveland Clinic Foundation laboratory. Glomerular filtration rate (GFR) was estimated using the simplified equation developed by the Modification of Diet in Renal Disease study. CKD was defined as an estimated GFR <60 mL/min/1.73m2. RESULTS: Overall, the age-standardized prevalences of GFR 60 to 89, 30 to 59, and <30 mL/min/1.73m2 were 39.4%, 2.4%, and 0.14%, respectively, in Chinese adults aged 35 to 74 years. The overall prevalence of CKD (GFR <60 mL/min/1.73m2) was 2.53%, representing 11,966,653 persons (1.31% or 3,185,330 men and 3.82% or 8,781,323 women). The age-specific prevalence of CKD was 0.71%, 1.69%, 3.91%, and 8.14% among persons 35 to 44, 45 to 54, 55 to 64, and 65 to 74 years old, respectively. The age-standardized prevalence of CKD was similar in urban (2.60%) and rural (2.52%) residents but was higher in south China (3.05%) than in north China (1.78%) residents. CONCLUSION: Although the prevalence of CKD in China was relatively low, the population absolute burden is substantial. These data warrant a national program aimed at detection, prevention, and treatment of CKD in China.

Adult↗
PubMed1990

Study on kidney function in female workers exposed to perchlorethylene.

1. Biochemical markers of kidney damage were examined in 16 female workers chronically exposed to tetrachlorethylene (TCE) in five dry-cleaning shops. The results were compared with those obtained in 13 females non-occupationally exposed to organic solvents. 2. The intensity of exposure was monitored by personal environmental monitoring. The time-weighed average exposure to TCE amounted to 157 mg m-3 (range 9-799 mg m-3). A satisfactory agreement was found between the concentration of TCE in ambient air sampled with the charcoal tube method and with a passive dosimeter. 3. The urinary excretion of lysozyme was increased in the exposed group. No difference was found in the urinary excretion of albumin, beta 2-microglobulin, lactate dehydrogenase, total proteins or glucose. The prevalence of abnormal values of biochemical parameters in the exposed group did not differ from that observed in the control group. No correlation was found between the level of TCE exposure and biochemical parameters. 4. The present study suggests that chronic exposure to TCE does not lead to renal damage.

Environmental Monitoring↗
PubMedDate not supplied

[Diabetes mellitus in advanced age. 7. Kidney function and behavior of blood pressure in long-term diabetic patients in the Newbrandenburg district].

Only 5.84 per cent of the 19,968 diabetics of the district Neubrandenburg had a diabetes duration of 15 and crore years (long term diabetics) in 1982. 44.9 per cent of these long term diabetics showed increased serum Oeatinine values and 54.7 per cent a hypertonia, where the fracture of each of these pathological influence parameters rose in conformability of the age. The frequency of hypertonia grew with rising serum creatinine value. The role of hypertonia for the excess mortality of the long term diabetics is well proved, where a persistent hypertonia possibly accelerates the renal failure stronger than a no more settled metabolism as it occurs in this group of patients. The high frequency of hypertonia values of blood pressure with the long term diabetics of a country district lets expect existing reserves in reading an improve of prognosis by optimizing the methods of antihypertensive therapy.

Aged↗
PubMed1991

[Recommendations for carrying out nuclear medicine kidney function tests with a gamma camera and computer].

Standardization of nuclear medicine renal studies is required in order to permit the comparison of study results of a patient obtained at different laboratories. Furthermore, standardization is a prerequisite for quality control of the analysis part of the procedure. The guidelines presented here are based on a survey carried out amongst nuclear medicine laboratories in Austria and have been edited and harmonized in a workshop organized by the Austrian Nuclear Medicine Society. The guidelines include detailed descriptions of the requirements of instrumentation, of the methods of acquisition, dosage and radiation dose of the commonly used radiopharmaceuticals and all aspects of the analysis of digital renograms. A comprehensive section deals with the determination of renal clearance from the renogram, further sections cover the usage and recommended methods of captopril renography for the diagnosis of unilateral renal artery stenosis and of the frusemide renogram for the diagnosis of nephropathy and uropathy.

Austria↗
PubMed1984

[Kidney function during radiosensitization with metronidazole].

Renal function was studied in patients with laryngeal cancer during radiation therapy performed under the conditions of mean fractionation in the presence of metronidazole radiosensitization up to the summary focal dose of 20 Gy. As compared to the findings before treatment an increase in the level of residual nitrogen, urea, uric acid and a decreased amount of creatinine in the plasma were noted. Decreased clearance of the urea, elevated Ambard's urosecretory constant were observed. The nature of these shifts was preserved even after the termination of subsequent radiation therapy up to the summary focal dose of 32 Gy without using the radiosensitogen. There is a possibility of a direct toxic effect of metronidazole on the renal tissue regardless of the state of oxygenation.

Blood Urea Nitrogen↗
PubMed1995

Reactivity of creatinine with alkaline 3,5-dinitrobenzoate: a new fluorescent kidney function test.

OBJECTIVES: To develop a new quantitative fluorometric assay for creatinine with enhanced specificity and inherent fluorescence sensitivity. DESIGN AND METHODS: Creatinine is reacted with 3,5-dinitrobenzoate under alkaline reaction conditions to produce a fluorophore. Alternatively, 3,5-dinitrobenzoyl chloride or methyl-3,5-dinitrobenzoate may be employed as reagents. Fluorophore development was evaluated for Group 1A bases under aqueous and mixed solvent conditions. RESULTS: The chemical reaction between creatinine and 3,5-dinitrobenzoate performed under highly alkaline conditions produced a fluorescent product with excitation and emission maxima near 410 and 475 nm, respectively. The reaction proceeds rapidly in the presence of group IA bases under both aqueous and mixed solvent conditions, in particular with water/dimethylsulfoxide and water/1,4-butanediol solvent systems containing 1.0 M LiOH. A linear calibration curve was obtained when the fluorescence intensity measured in microamperes was plotted versus creatinine concentration in the range of 5-50 mumol/L. The detection limit for creatinine was well below 1 mumol/L. CONCLUSIONS: A simple, sensitive and highly specific fluorometric method for the determination creatinine has been developed.

Alkalies↗
PubMed1997

[Qualitative and quantitative kidney function testing in dogs using MAG3 clearance].

In the presented study 99mTc-MAG3 clearance measurements were undertaken in 14 dogs during renal scintigraphic examination. Of these dogs, 10 showed no renal impairment, the other 4 exhibited clinically manifested nephropathy. It was the aim of these examinations to determine if this type of clearance measurement that is routinely used in human medicine is suitable for diagnosis of canine nephropathy. An algorithm for the calculation of the MAG3-Clearance developed for humans was modified. The clearance measurement can be performed during the renal scintigraphic procedure without any difficulties. In the group of dogs with no renal impairment the clearance values ranged between 6.4 and 8.0 ml/min/kg, whereas in the group of patients exhibiting nephropathies the values ranged between 2.0 and 2.7 ml/min/kg. The suitability of the method for its use in dogs needs to be confirmed with higher patient numbers. In addition, further studies are necessary to precisely assess the correlation between measured clearance values and effective renal plasma flow in dogs.

Animals↗
PubMed1989

[Kidney function in women with pregnancy-induced hypertension].

The authors examined 74 women in III trimester (29-40 week), among them 44 women with hypertension induced by pregnancy (group examined) and 30 healthy women (control group). The blood serum of these women was studied for: creatinine, urea, uric acid, electrolytes K+ and Na+. Besides, the blood was studied for acid-base equilibrium (apparatus Corning type 128). The 24-hour urine of the two groups was studied for the concentrations of ions: 1) ammonium (NH4+), 2) hydrogen (H+) and 3) potassium and sodium (K+ and Na+). The authors also made the endogenic creatinine clearance (Ckr). The results were calculated statistically. The women with hypertension induced by pregnancy had in their blood serum an increase in the concentration of creatinine, urea and uric acid. As to the parameters of acid-base equilibrium, the authors found an increase in pCO2. Besides, the women with this kind of hypertension had: a decrease in the excretion of ions NH4+ and H+ in the urine, a decrease of Ckr with electrolytes K+ and Na+ being within the normal range.

Acid-Base Equilibrium↗
PubMed1981

[Endotoxin effect on intravascular volume and kidney function in an acute experiment in the rat].

The effect of intravenous endotoxin (Sal. abortus equi) in a semilethal dose in rats was very individual. Animals showing a drop in creatinine clearance were termed sensitive (E II), and animals without effect on the creatinine clearance non sensitive (E I). In the sensitive animals a reduction of intravascular space by albumin loss into the extravascular space, a decrease of renal blood flow and an average fall in creatinine clearance of 40% were found. The non sensitive animals (E I), on the other hand, showed no significant change in albumin space but, in contrast to E II, their hematocrit fell, a fact interpreted as vasodilatation and inflow of fluid. In these animals (E I) no change in creatinine clearance was measured. Orthograde tubular perfusion of endotoxin through the loop of Henle elicited no tubular glomerular feedback response. In these sensitive animals (E II), the absence of tubular glomerular feedback vasoconstriction, hypovolemia and a fall in blood pressure suggest a prerenal cause for this type of acute renal failure. Additional factors responsible for acute renal failure are discussed.

Animals↗
PubMed1982

[The cardiovascular risk profile of long-term diabetics and its relation to kidney function].

Of 250 diabetics with a duration of the disease between 15 and 54 years the relations between the renal function and the cardiovascular risk profile were examined. The clearly increased serum creatinine values the frequency of persons with overweight was lower than in diabetics with very favourable creatinine levels. The increasing concentration of the serum led to an increase of the frequency of hyperuricaemia, whereas the frequencies of hypertension hypertriglyceridaemia and hypercholesterolaemia did not show any significant changes. The habits of smoking of long-term diabetics with and without renal insufficiency did not differ from each other qualitatively. Particularly after the 50th year of age long-term diabetics more frequently had diabetic blood-relatives than newly detected diabetic patients of the same age. Patients with familial occurrence of diabetes (relatives of 1st degree) in comparison to diabetics without known diabetic relatives showed an identical cardiovascular risk profile, so that there is no influence of the heredity of diabetes on the formation of the non-diabetic sizes of influence of the metabolic syndrome.

Adolescent↗
PubMed1977

[Determination of homeostatic kidney function in the diagnosis of chronic glomerulonephritis].

The latent and hypertonic forms of the course of compensated nephritides more frequently make difficulties concerning the differential diagnosis between a chronic glomerulonephritis and a chronic pyelonephritis. According to the results achieved the determination of the renal processes furthering homoeostasis gives the possibility to demarcate the two diseases. A certain reduction of the creatinine clearance (to less than 90 ml/min) and of the maximum water diuresis (to less than 10.0 per 100 ml glomerular filtrate) is suitable for the latent form of the chronic glomerulonephritis. On the other hand, a reduction of the ammonia secretion (to less than 35 per 100 ml glomerular (filtrate) and of the total H+-ion secretion (to less than 50 per 100 ml glomerular filtrate) in the determination after Alkinton is characteristic for the chronic pyelonephritis. In the hypertensive form of the course of the chronic glomerulonephritis in contrast to the same form in chronic pyelonephritis a reduction of the maximum water diuresis to less than 7.5, of the clearance of the "osmotically free" water to less than 6.0, of the titrable acidity to less than 25 is the result. Here the ammonia quotient transgresses 45%. In chronic pyelonephritis the titrable acidity in considerably increased and the ammonia genesis relatively decreased (to less than 45%).

Ammonia↗
PubMed1989

Monitoring kidney function in diabetic nephropathy.

We investigated the validity of a one plasma sample method (I) compared with a multiple plasma sample method (II) for routine clinical determination of glomerular filtration rate (GFR) in 35 insulin-dependent diabetic patients suffering from nephropathy. GFR was measured after an intravenous bolus injection of 100 microCi 51Cr-EDTA by determination of plasma radioactivity in venous blood samples taken from the other arm 180, 200, 220 and 240 min after the injection (II). The plasma radioactivity in the sample drawn 240 min after injection was used in method I. During the mean investigation period of 32 months (12-62 months) a total of 184 GFR determinations were performed. The average interval between the GFR measurements was 6 months (1-21 months). In 127/184 of the study intervals method I indicated a decrease in GFR. The corresponding figure for method II was almost identical, 130/184. The mean decline in GFR was 8.1 +/- 7.2 and 7.8 +/- 6.9 ml year-1 1.73 m-2 using methods I and II, respectively (NS). The methods essentially provided the same GFR values in absolute terms (r = 0.98, P less than 0.001). We conclude that the one plasma sample method can be used as a valid routine technique in non-uraemic patients with nephropathy.

Adult↗
PubMed1992

[Long-term antihypertensive therapy of diabetic patients with felodipine. Effects of treatment on blood pressure and kidney function parameters].

AIMS: Detection of possible effects on renal function parameters of long-term antihypertensive treatment administered to patients with diabetes mellitus. STUDY DESIGN: Prolongation of an open trial, initially planned for one year, on the effect of felodipine 10 mg/day in diabetics (Fortschr. Med. 109 (1991), 53-56). Continued treatment of 7 hypertensive insulin-dependent diabetics (mean age 58 +/- 3 years, HbA1 8.2 +/- 0.3%) over a period of between 24 and 32 months. RESULTS: The lowered blood pressure (from 160/94 to 150/82 mmHg; p less than 0.05) persisted. In the first 6 months of treatment, urinary albumin excretion (UAE) remained constant. Thereafter it increased (p less than 0.05 as compared with the figure seen after 6 months' treatment) to a degree that varied from one patient to another; overall, the UAE figures showed a relatively large intra-individual fluctuation during long-term therapy. Metabolic parameters remained uninfluenced by felodipine. CONCLUSIONS: It cannot be excluded that progression of diabetic renal disease cannot be adequately prevented by long-term treatment with calcium antagonists such as felodipine.

Blood Pressure↗
PubMed1993

Effects of atenolol and enalapril on kidney function in hypertensive diabetic patients.

The aim of the study was to evaluate the efficacy of enalapril and atenolol in decreasing the severity of proteinuria in hypertensive patients suffering from insulin-dependent diabetes mellitus. We studied 20 hypertensive patients. All patients had proteinuria (> 3 g/24 h) and were receiving insulin treatment. Proteinuria was measured monthly in the run-in period (3 months) and during the active drug treatment (8 months). Glomerular filtration rate, effective renal plasma flow, filtration fraction, and total renal resistance were determined after the run-in and treatment periods. The patients were randomly assigned to treatment with enalapril 20 mg/day or atenolol 100 mg/day for 8 months. In both groups blood pressure decreased significantly. After 8 months' treatment, severity of proteinuria significantly decreased both in the enalapril-treated group and in the group receiving atenolol. Glomerular filtration rate and effective renal plasma flow significantly increased, while total renal resistance decreased in the patients given enalapril, whereas glomerular filtration rate, renal plasma flow, and total renal resistance significantly decreased in the patients given atenolol. The results of this study show that enalapril and atenolol reduce proteinuria in hypertensive diabetic patients by a mechanism related to their antihypertensive effects; furthermore, the beneficial effects of enalapril might be also linked to intrarenal effects.

Adult↗
PubMed1997

[A comparison between an ionic paramagnetic contrast agent (Gd-DTPA) and a nonionic one (Gd-DTPA-BMA) in functional kidney evaluation with magnetic resonance].

INTRODUCTION: The combination of TGE sequences with bolus injection of paramagnetic contrast agents permits to study renal function and perfusion. We studied renal function with both an ionic (Gd-DTPA) and a nonionic paramagnetic contrast agent (Gd-DTPA-BMA) to compare their kinetics in normal kidneys. MATERIAL AND METHODS: Twenty MR examinations were performed on 20 subjects with normal renal function. Ten subjects were examined after i.v. injection of Gd-DTPA and the other ten subjects after i.v. injection of Gd-DTPA-BMA. MR examinations were performed on a Philips ACS II unit (1.5 T). Two sequences were acquired in all cases; an SE coronal T1-weighted sequence (TR/TE = 600/19 ms) and a TGE coronal T1-weighted sequence (TR/TE = 12/5 ms, flip angle = 25 degrees) performed after bolus injection of the contrast agent at 0.1 mmol/kg. Signal intensity time curves were obtained in all the cases. The signal intensity of the cortex, corticomedullary junction, medulla and the pyelocaliceal system of each kidney was measured using a region of interest (ROI). Signal intensity curves were analyzed considering some quantitative parameters such as the area under the curve (AUC), the peak (P) and the time to peak (T-P). RESULTS: In the subjects with normal renal function, four phases were demonstrated after the i.v. injection of either Gd-DTPA or Gd-DTPA-BMA, namely the cortical phase, the cortico-medullary junction phase, the medullary phase and the pyelocaliceal system phase. No statistically significant differences between the two agents were demonstrated in signal intensity time curves and quantitative parameters. CONCLUSIONS: Gd-DTPA and Gd-DTPA-BMA showed the same efficacy in renal function studies.

Analysis of Variance↗