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PubMed1992

[Effects of partial nephrectomy on the pharmacokinetics and pharmacodynamics of recombinant human erythropoietin (SNB-5001) in rats].

The present study examined the pharmacokinetic and pharmacodynamic profiles of recombinant human erythropoietin (SNB-5001) in partially nephrectomized rats. The plasma level of SNB-5001 was measured by a 2-step enzyme immunoassay. The plasma disappearance curve after intravenous injection of SNB-5001 (50 U/kg) in these rats showed a biexponential pattern similar to that in non-treated rats, conforming to a two-compartment model. However, the total body clearance was reduced, the plasma half life was prolonged and the area under the concentration-time curve of SNB-5001 was increased by the partial nephrectomy. The distribution volumes of SNB-5001 were almost the same as those in non-treated rats. It is suggested that the kidney may contribute to the elimination of SNB-5001. Dose-dependent increases of reticulocytes, red blood cells, hemoglobin and hematocrits were observed after seven repetitive intravenous injections of SNB-5001 in both partially nephrectomized rats and non-treated rats. Hemopoietic responses were calculated by subtracting the initial values from the values after SNB-5001 injections of each hematological parameter (reticulocytes, red blood cells, hemoglobin and hematocrits). Hemopoietic responses in partially nephrectomized rats were apparently stronger than those in non-treated rats. These results suggest that the reduction of clearance by the partial nephrectomy may contribute to the hemopoietic responses, in addition to suggesting that the uremic conditions do not inhibit the effects of SNB-5001 in partially nephrectomized rats.

Animals↗
PubMed1995

Changes of hepatic microsomal oxidative drug metabolizing enzymes in chronic renal failure (CRF) rats by partial nephrectomy.

Male SD rats, 7-weeks-old, were used to investigate the changes in the hepatic drug metabolizing system of chronic renal failure (CRF) model rats. Partial nephrectomy (5/6) was performed in a two-stage surgical procedure. After nephrectomy, the rats were housed under regular conditions at least 21 days. After confirming the CRF states, trimethadione (TMO, 100 mg/kg, i.p.) was administered for evaluation of the hepatic drug metabolizing capacity; the ratio of dimethadione (DMO: the only metabolite of TMO) to TMO (DMO/TMO) in the serum and the dialysate from the blood microdialysis method were ascertained. The hepatic drug metabolizing enzyme contents and activities were also determined. In the CRF rats, the DMO/TMO ratios decreased significantly; total cytochrome P450 (CYP) contents, aminopyrine N-demethylase activity and delta-aminolevulinic acid synthetase activity also decreased significantly in the CRF rats. The extent of the alterations of these enzyme contents and activities correlated well with the severity of the CRF states evaluated by the serum blood urea nitrogen and creatinine concentrations. With Western blot analysis, the levels of CYP2C6, CYP2C11 and CYP3A2 decreased considerably in the CRF rats. These results suggest that CRF states induce not only a reduction of renal function but also an alteration of hepatic metabolism.

Animals↗
PubMed1989

[The effects of nephrectomy and angiotensin converting enzyme inhibitor on production and clearance rates of angiotensinogen in dogs].

The clearance and production rates of plasma angiotensinogen of normal dog, nephrectomized dog and angiotensin converting enzyme inhibitor (ACEI) administered dog were calculated. Plasma angiotensinogen was measured by adding excessive dog renin to the plasma sample. The clearance rate was 4.4, 4.0 and 3.8 ml/kg/hr and the production rate was 9.6, 21.6 and 7.6 micrograms/kg/hr, respectively. After nephrectomy, the clearance rate of angiotensinogen decreased only 10 percent but the production rate increased more than twice. These results mean that the kidney does not play an important role in the clearance of angiotensinogen but has some influence on its production. This increase in production rate due to nephrectomy may mean that the kidney has some inhibitory effect on the secretion of angiotensinogen from the liver but this phenomenon is not able to explain by much less hydrolysis of angiotensinogen. By the administration of ACEI, not only the clearance rate but also the production rate of plasma angiotensinogen decreased as compared with control dog, but the balance between them resulted in the decreased plasma angiotensinogen concentration. These results show that the decreased production rate was greater than the decreased clearance rate in ACEI administered dog.

Angiotensinogen↗
PubMed2003

Hand-assisted bilateral nephrectomy in a patient with adult polycystic kidney disease.

CONTEXT: Dominantly autosomal polycystic disease is characterized by multiple bilateral and non-functional cysts, which lead to progressive kidney failure. OBJECTIVE: Our objective was to report on a case of hand-assisted bilateral nephrectomy in a 28-year-old female patient with adult polycystic disease and recurring pyelonephritis in a kidney transplant program. CASE REPORT: A hand-assisted bilateral nephrectomy was performed through a supra-umbilical median incision of approximately 6 cm, and with 3 ports of 10 mm. The length of the surgery was 3 hours and 15 minutes. The kidneys were removed after the aspiration of some cysts through the supra-umbilical incision. Pain control was achieved via the use of analgesics. The blood loss during surgery was 160 ml. During the postoperative period, the patient developed right-side pneumothorax, which was drained with no further occurrence. This drain was kept in place for 48 hours. The length of hospitalization was 4 days.

Adult↗
PubMedDate not supplied

Retroperitoneoscopic nephrectomy in benign pathology.

INTRODUCTION: We report our experience with 43 retroperitoneal laparoscopic nephrectomy for benign kidney disease. MATERIALS AND METHODS: All patients had a poor function from obstructive uropathology and renal atrophy. None of these patients had a previous lumbotomy. Retroperitoneoscopy was performed with 4 trocar port technique in a lateral position. The retroperitoneal space is created by using a Gaur's balloon made of sterile glove. The approach to vascular pedicle was done posteriorly and vessels were clipped by metal and Hem-o-lock (Weck Closure Systems, North Carolina, USA) clips. The sample was intact extracted in an Endo-Bag prolonging one trocar incision. RESULTS: Median operative time was 160 minutes and median blood loss was 200 mL. Four cases (9%) were converted to open surgery: one case due to bleeding and 3 cases due to technical difficulties regarding perirenal adherences. Most patients (39) checked out from the Hospital in day two. Four of them were left over 3 days due to wound complications. CONCLUSIONS: Retroperitoneoscopy offers a safe, effective and reproductive access to nephrectomy for benign pathologies.

Adult↗
PubMed1983

Degradation of 125I-labelled prolactin in the rabbit: effect of nephrectomy and prolactin infusion.

Hyperprolactinaemia in patients with chronic renal disease undergoing dialysis has prompted the investigation of the relative roles of liver and kidney in the degradation of prolactin. Male rabbits were acutely nephrectomized, and compared with intact animals with or without prolactin infusion. Prolactin degradation was followed after intravenous injection of 125I-labelled ovine prolactin. Measurements were made of peptide-bound 125I and 125I-labelled degradation products in plasma, liver, kidney, bile, urine and muscle and total thyroid radioactivity. A significant (P less than 0.01) reduction in the metabolic clearance rate of 125I-labelled prolactin was observed due to nephrectomy, with double the accumulation of 125I-labelled peptides in the livers in this group. Prolactin infusion of nephrectomized animals had a further and larger effect than nephrectomy alone on prolactin degradation. Metabolic clearance rate significantly (P less than 0.01) decreased from 5.5 ml/min per kg in nephrectomized rabbits to 0.8 ml/min per kg with prolactin infusion. The accumulation of 125I-labelled prolactin degradation products in the blood was significantly (P less than 0.01) lower in this group of animals and the amount of peptide-bound 125I in plasma at 60 min after 125I-labelled prolactin administration was significantly (P less than 0.01) higher. Liver degradation of prolactin in the absence of exogenous hormone appears to be sufficient to maintain an approximately normal half-life for prolactin in plasma (intact t 1/2 = 6.8 min; nephrectomized t 1/2 = 8.5 min).(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed2006

Endothelial function predicts the development of renal damage after combined nephrectomy and myocardial infarction.

It was demonstrated that individual renal endothelial dilatory function of the healthy rat predicts susceptibility to subsequent renal damage induced by 5/6 nephrectomy. In addition, it is reported that myocardial infarction (MI) that was performed upon unilateral nephrectomy (UNx) induced highly variable renal damage. Therefore, whether the variability in renal damage after MI could be explained by the variation in individual renal endothelial function before the induction of injury was studied. Endothelium-dependent relaxation to acetylcholine was investigated in vitro in small arteries that were isolated from the extirpated kidney at UNx. MI was induced 1 wk after UNx by ligation of the left coronary artery. Proteinuria and systolic BP were evaluated weekly for 16 wk thereafter using metabolic cages and the tail-cuff method, respectively. Upon termination of the study, focal glomerulosclerosis was evaluated by histology as an additional marker of renal damage. After MI, nephrectomized male Wistar rats (n = 15) gradually developed variable proteinuria, ranging from 20 to 507 mg/24 h at week 16, with an average systolic BP of 131 +/- 7 mmHg. The individual renal endothelial function of the healthy rats predicted the extent of renal damage in terms of proteinuria (r = -0.62, P = 0.008) and focal glomerulosclerosis (r = -0.70, P = 0.003). The individual level of renal endothelial function in the healthy rat is able to predict the severity of renal damage that is induced by MI. Further exploration of the underlying mechanisms may lead to discovery of preventive renoprotective therapies.

Acetylcholine↗
PubMed1992

Acute unilateral nephrectomy elicits a specific increase in plasma of peptides derived from the N-terminal region of proopiomelanocortin.

Acute unilateral nephrectomy (AUN) causes natriuresis from the contralateral kidney through neurohumoral reflex pathways that involve an increase in the plasma of peptides derived from the N-terminal region of the adrenocorticotropic hormone (ACTH)/beta-endorphin precursor proopiomelanocortin (POMC). To determine the specificity of these humoral changes, the concentrations in plasma of ACTH and two peptides arising from the N-terminal fragment (NTF) of POMC, NTF32-49 and gamma-melanocyte-stimulating hormone (gamma-MSH), and of another natriuretic peptide, atrial natriuretic peptide (ANP), were measured by RIA with highly specific antisera to these epitopes. Group I experiments followed the course of sodium excretion (UNaV) for 120 min after AUN or sham nephrectomy. UNaV more than doubled within 60 min of AUN, and this natriuresis was maintained for the remainder of the experiment, whereas UNaV in sham rats did not change. There was no difference in plasma immunoreactive (ir) ACTH or ir-ANP concentrations between sham and AUN rats 120 min after the procedure, but plasma ir-NTF concentration was double in AUN rats compared with sham (P < 0.03). In Group II experiments, animals were killed 30, 60, 90, or 120 min after AUN and the urinary response related to peptide concentrations in plasma. UNaV rose rapidly after AUN, reaching a maximum value within 45 min that again was double the control value and remained stable for the duration of the experiment, up to 120 min after AUN. There was no significant change in ir-ACTH or ir-ANP at any point after AUN compared with values in sham AUN rats. However, plasma concentrations of both ir-NTF and ir-gamma-MSH were elevated 30 min after AUN and reached values at 120 min that were again double the values in sham rats (P < 0.05 for both).(ABSTRACT TRUNCATED AT 250 WORDS)

Acute Kidney Injury↗
PubMed2001

Congestive heart failure caused by aortocaval fistula after nephrectomy.

We treated a 66-year-old man and a 69-year-old woman with high output cardiac failure due to aortocaval fistula. They underwent nephrectomy 40 and 36 years ago, respectively. They suffered from heart failure for a very long time. However, the etiology was not elucidated until recently. The aortogram revealed massive shunt from the aorta to the inferior vena cava via the right renal artery. Three-dimensional computerized tomography clearly delineated the aortocaval fistula. Surgical closure of the fistula promptly improved heart failure. We stress the importance of history taking concerning nephrectomy and the importance of abdominal auscultation in high output cardiac failure.

Aged↗
PubMed2005

Solitary brain metastasis from renal cell carcinoma 15 years after nephrectomy: case report.

A 77-year-old man presented with a metastatic brain tumor 15 years after nephrectomy for a renal cell carcinoma. Neurological examination showed recent memory disturbance and slight right hemiparesis. Magnetic resonance imaging revealed a round well-demarcated mass extending from the left thalamus to the left trigone of the lateral ventricle. Preoperative angiography showed tumor staining. Surgery was performed by opening the inferior temporal sulcus. Only biopsy could be performed because of extensive bleeding from the tumor. Histological examination identified metastatic renal cell carcinoma. Gamma knife surgery was performed which resulted in resolution of his hemiparesis. Metastatic renal cell carcinoma should be considered even if nephrectomy was performed 10 or more years before presentation.

Aged↗
PubMed2007

CT diagnosis of chyluria after partial nephrectomy.

OBJECTIVE: The purpose of this study was to describe the CT diagnosis of chyluria after partial nephrectomy. CONCLUSION: Fat in the bladder can be identified on CT after partial nephrectomy. This finding is caused by chyluria secondary to lymphatic injury and should not be mistaken for other abnormalities. Our study population did not need treatment of chyluria.

Adult↗
PubMed1977

Malposition of the colon in right renal agenesis, ectopia, and anterior nephrectomy.

Right renal agenesis, ectopia, or anterior nephrectomy can be identified by a characteristic malposition of the right colon. Barium enemas show that the posterior portion of the right colic (hepatic) flexure occupies the area of the right renal fossa. This change in position of the right colon was not observed as a normal variant in 100 randomly selected patients but was present in each of eight patients with agenesis, ectopia, or anterior nephrectomy. This malposition should not be mistaken for internal hernia, malrotation, or displacement by tumor mass or organomegaly. Nonvisualization of the right kidney on excretory urography with normal position of the colon excludes agenesis or ectopia as diagnostic considerations.

Adult↗
PubMed2002

MR angiography and preoperative evaluation for laparoscopic donor nephrectomy.

OBJECTIVE: The purpose of our study was to evaluate the effectiveness of gadolinium-enhanced MR imaging in imaging arterial, venous, and ureteric anatomy in a group of potential laparoscopic renal donors and to compare our findings with those established at surgery. SUBJECTS AND METHODS: Sixty-four consecutive patients underwent successful laparoscopic donor nephrectomy. Imaging of the kidneys was performed before surgery with MR imaging and breath-hold three-dimensional gadolinium-enhanced MR angiography. All studies were reviewed prospectively by one of two attending radiologists. Results were compared with findings at the time of laparoscopic nephrectomy. RESULTS: Of the 64 patients, MR imaging and MR angiography identified 30 patients with normal arterial, venous, and ureteric anatomy, and concordance was found at surgery in 29 of these patients. Vascular anomalies were depicted on MR imaging in 34 patients, with complete concordance at surgery in 29 patients. The use of MR angiography for revealing arterial anomalies had a sensitivity of 89.4%, specificity of 94.1%, and accuracy of 90.6%. For venous anomalies, there was a sensitivity of 98.3%, specificity of 100%, and accuracy of 98.4%. No important utereric anomalies were identified at surgery or on MR imaging. CONCLUSION: Renal MR imaging and gadolinium-enhanced MR angiography provide a safe, accurate, and minimally invasive means of comprehensive assessment of the potential living renal donor.

Adult↗
PubMed1976

Residual kidney function after unilateral nephrectomy. Pre- and postoperative estimation by renography and clearance measurements.

The residual kidney function was predicted from preoperative renography and determination of the glomerular filtration rate (GFR) in 57 patients undergoing unilateral nephrectomy for cancer, postrenal obstruction or renovascular hypertension. Postoperative GFR measurements were carried out 6-36 months after the operation. In eleven patients where the kidney removed had no function, no significant difference was found between pre- and postoperative GFR values. In 46 patients where the kidney removed had some function, the preoperative estimate was a little too high in only two patients. In this group, the postoperative GFR on an average amounted to 42% above the preoperatively predicted value. We conclude that the combination of 51Cr-EDTA clearance and renography is a reliable, non-invasive method for determination of the minimum residual kidney function before unilateral nephrectomy is carried out.

Adult↗
PubMed1986

Treatment of renovascular hypertension by unilateral nephrectomy. A follow-up study in patients above 60 years of age.

The long term results of surgical intervention in 26 elderly patients with renovascular hypertension are presented. All patients were above 60 years of age at the day of operation. The majority of the patients had atherosclerotic renovascular disease with only one case of fibromuscular dysplasia. Several patients had severe extrarenal atherosclerotic disease. The diagnosis of renovascular hypertension was based upon the results of isotope renography, renal arteriography and renal vein catheterization. All patients underwent unilateral nephrectomy. Notably, no deaths or complications occurred in relation to surgery. At the follow-up study, blood pressure was lowered and the requirement for antihypertensive drugs reduced in 86% of the patients. We conclude that unilateral nephrectomy in elderly high risk patients with renovascular hypertension is a safe and efficient procedure.

Aged↗
PubMed1991

Nd: YAG contact laser in partial nephrectomy. An experimental study in piglets.

The Nd: YAG contact laser technique with 12 W power output was used in partial nephrectomies in six piglets. Blood loss, total time and number of ligatures needed for haemostasis were compared in six partial nephrectomies performed with a steel scalpel. Mean blood loss was 53 g with the laser and 108 g with the steel scalpel (p less than 0.04). The mean time needed for haemostasis were 9.5 and 16.2 min respectively (p = 0.2) and the average number of ligatures required 1.5 and 8.8, respectively. The mean temperature rise at 5, 10 and 20 mm distance from the resection line was 5.3, 1.2 and 0.3 degrees C, respectively. The use of laser reduced blood loss and shortened the operation time. Further studies are needed concerning renal function after kidney surgery with a laser.

Animals↗
PubMed1991

Efficacy and complications of the Nd:YAG laser in partial nephrectomy: experimental study in piglets.

Twenty-four partial nephrectomies were performed in 18 piglets using either the combination Nd:YAG laser technique (contact and noncontact) or a steel scalpel. Additional haemostasis was attempted with ligatures. Blood loss, operation time, and number of ligatures were compared in the two treatment groups. Twelve piglets had a two-week follow-up. The mean blood loss with the laser was 72 +/- 10 g and 83 +/- 13 g with the steel scalpel (no significant difference). The resection time until complete haemostasis was 9.8 +/- 0.9 min with the laser and 14.3 +/- 1.3 min with the steel scalpel (p = 0.0076). The number of ligatures needed for complete haemostasis was 2.8 +/- 0.4 with the laser and 7.5 +/- 1.0 with the steel scalpel (p = 0.0051). Three piglets in the steel scalpel group developed urinomas. There were two perirenal abscesses, one in each group. In the steel scalpel group there was one intussusception. In conclusion, it seems that the combination Nd:YAG laser method offers no definitive advantage over the standard technique for partial nephrectomies in the pig.

Animals↗