Renal Endothelin System in Obstructive Jaundice: Its Role in Impaired Renal Function of Bile-Duct Ligated Rats

1997 ◽  
Vol 92 (6) ◽  
pp. 579-585 ◽  
Author(s):  
Herbert J. Kramer ◽  
Kriemhild Schwarting ◽  
Angela Backer ◽  
Harald Meyer-Lehnert
Keyword(s):  
Renal Failure ◽  
Renal Function ◽  
Acute Renal Failure ◽  
Glomerular Filtration Rate ◽  
Bile Duct ◽  
Obstructive Jaundice ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
Kidney Weight ◽  
Duct Ligation

1. Obstructive jaundice predisposes the kidney to acute renal failure. Endothelin (ET), a potent renal vasoconstrictor and modulator of the tubular action of arginine vasopressin, has been suggested to play a pathogenetic role in acute renal failure. In the present study we therefore investigated renal function and the renal ET system in rats on day 4 after bile-duct ligation (BDL) or sham-operation (SO), without (n = 7 in each group) and with treatment with bosentan, a combined ETA/ETB receptor blocker, (n = 5 in each group). 2. On day 4 after BDL, serum bilirubin had increased to 226 ± 10 μmol/l (SEM) as compared with 6 ± 2 μmol/l in SO rats. Endogenous creatinine clearance, an index of glomerular filtration rate, was significantly reduced to 0.7 ± 0.1 ml min−1 g−1 of kidney weight after BDL as compared with 1.1 ± 0.1 ml min−1 g−1 of kidney weight after SO (P < 0.05). Bosentan prevented the decrease in glomerular filtration rate (1.0 ± 0.2 ml min−1 g−1 of kidney weight), as well as polyuria and defective concentrating ability, in BDL rats. 3. Plasma ET concentration on day 4 after surgery (28.2 ± 1.5 pmol/l) was higher (P < 0.01) in BDL than in SO rats (12.9 ± 1.5 pmol/l) and rose further in bosentan-treated BDL and SO rats (43.4 ± 5.1 compared with 21.9 ± 6.6 pmol/l). Urinary ET excretion was significantly higher in BDL rats than in SO rats (1.58 ± 0.22 compared with 1.28 ± 0.18 pmol 24h−1 100 g−1 of body weight; P < 0.05). 4. ET synthesis by glomeruli isolated from BDL rats was lower [81 ± 19 fmol h−1 (mg of protein)−1] than that from SO-rats [139 ± 28 fmol h−1 mg of protein)−1; P < 0.05], whereas papillary ET synthesis was higher in BDL [10 ± 3 fmol h−1 (mg of protein)−1] than in SO rats [4 ± 1 fmol h−1 (mg of protein)−1; P < 0.05]. 5. The results indicate that BDL is associated with increased plasma ET concentration and suppression of GFR. Enhanced renal inner medullary collecting-duct ET synthesis, which is reflected by increased urinary ET excretion, may reduce distal tubular water absorption in BDL rats. Increased circulating and renal papillary ET synthesis may thus contribute to renal dysfunction and predispose the kidney to acute renal failure in obstructive jaundice.

Renal Function in Chronic Obstructive Jaundice: A Micropuncture Study in Rats

1978 ◽  
Vol 54 (6) ◽  
pp. 649-659 ◽  
Author(s):  
Marjorie E. M. Allison ◽  
N. G. Moss ◽  
Mary M. Fraser ◽  
J. W. Dobbie ◽  
C. J. Ryan ◽  
...  
Keyword(s):  
Renal Function ◽  
Glomerular Filtration Rate ◽  
Hydrostatic Pressure ◽  
Bile Duct ◽  
Obstructive Jaundice ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
Bile Duct Ligation ◽  
Chronic Obstructive ◽  
Duct Ligation

1. We have studied kidney structure and function in female Sprague—Dawley rats with chronic obstructive jaundice after bile-duct ligation and section and in age-matched sham-operated control animals. 2. High bile-duct ligation and section resulted in immediate hyperbilirubinaemia and progressive hepatomegaly with histological evidence of bile-duct proliferation and periportal inflammation and fibrosis. 3. Only 20% of the jaundiced animals developed ascites, but 42% became hypotensive and died during preparation for micropuncture. 4. In the surviving rats there was no significant change in blood pressure, whole-kidney glomerular filtration rate, single-nephron glomerular filtration rate or calculated glomerular capillary hydrostatic pressure from control animals. However, renal plasma flow was increased so that whole-kidney filtration fraction was low. These changes were largely reversed by choledochoduodenostomy. 5. Proximal tubular reabsorption in the jaundiced group was not different from control rats, although the inulin (urine/plasma) ratio was significantly reduced, indicating diminished reabsorption distal to the proximal convoluted tubule. Proximal intratubular hydrostatic pressure was significantly increased in some nephrons. 6. Electron microscopy of the glomeruli from the jaundiced animals revealed evidence of marked increase in activity of both epithelial and endothelial cells. 7. Rats who survive chronic obstructive jaundice for 3–4 weeks have changes in renal function and also structural changes suggestive of diminished glomerular permeability.

Acute kidney injury

2018 ◽  
Author(s):  
Aron Chakera ◽  
William G. Herrington ◽  
Christopher A. O’Callaghan
Keyword(s):  
Acute Kidney Injury ◽  
Renal Failure ◽  
Renal Function ◽  
Acute Renal Failure ◽  
Glomerular Filtration Rate ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
Urine Volume ◽  
Kidney Injury ◽  
Rapid Decrease

Acute renal failure (also referred to as acute kidney injury) refers to a rapid decrease in renal function; it is reflected by an increase in blood urea and creatinine and is often associated with oliguria (a urine volume of less than 400 ml/24 hours). It usually develops over days to weeks. Acute kidney injury has been variously classified, but the current classifications are based on the glomerular filtration rate (or creatinine), looking at changes from baseline, and the presence of oliguria or anuria. The potential etiologies of acute kidney injury are usually considered anatomically under the headings prerenal, renal (intrinsic), and postrenal. This chapter looks at the etiology, symptoms, clinical features, demographics, complications, diagnosis, and treatment of acute kidney injury.

Impaired Renal Function in Obstructive Jaundice: Enhanced Glomerular Thromboxane Synthesis and Effects of Thromboxane Receptor Blockade in Bile Duct-Ligated Rats

1995 ◽  
Vol 88 (1) ◽  
pp. 39-45 ◽  
Author(s):  
Herbert J. Kramer ◽  
Kriemhild Schwarting ◽  
Angela Bäcker
Keyword(s):  
Renal Function ◽  
Glomerular Filtration Rate ◽  
Bile Duct ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
Bile Duct Ligation ◽  
Urine Volume ◽  
Thromboxane A2 ◽  
H2 Receptor Antagonist ◽  
Duct Ligation

1. Patients with obstructive jaundice are especially susceptible to acute renal failure. We have previously observed that in rats with bile duct ligation impaired renal function is associated with increased urinary thromboxane excretion. 2. In the present study we therefore investigated, in rats with bile duct ligation, renal function, urinary thromboxane excretion and thromboxane B2 synthesis by isolated glomeruli as well as the effects of the thromboxane A2/prostaglandin H2 receptor antagonist Daltroban on renal function in rats with bile duct ligation as compared with sham-operated rats. 3. On the fourth day after bile duct ligation (n = 7 rats) endogenous creatinine clearance as an estimate of glomerular filtration rate was significantly reduced to 0.74 ± 0.05 (SEM) as compared with 1.06 ± 0.09 ml min−1 g−1 kidney weight in sham-operated rats (n = 7, P < 0.01). In rats with bile duct ligation, urine volume was slightly increased, whereas urinary sodium (Na+) (P < 0.001) and potassium (K+) (P < 0.01) excretion as well as urine osmolarity (P < 0.05) were significantly reduced and lower than in sham-operated rats. 4. Urinary thromboxane excretion was significantly higher in rats with bile duct ligation than in sham-operated rats: 116.6 ± 22.3 versus 56.8 ± 10.2 pmol 24h−1 100 g−1 body weight (P < 0.05). Thromboxane B2 synthesis in glomeruli isolated from rats with bile duct ligation was also significantly higher than in sham-operated rats: 12.6 ± 2.0 versus 6.4 ± 0.9 pmol h−1 mg−1 protein (P < 0.05). 5. The thromboxane A2/prostaglandin H2 receptor antagonist Daltroban normalized glomerular filtration rate in a second group of rats with bile duct ligation (n = 7) to 1.03 ± 0.08 (P < 0.01) and slightly increased it in sham-operated rats (n = 7) to 1.24 ± 0.11 ml min−1 g−1 kidney weight (not significant). Daltroban, while without effects on urine volume and osmolarity in sham-operated rats, further increased urine volume and decreased osmolarity in rats with bile duct ligation after surgery. After surgery Daltroban reduced fractional Na+ and K+ excretion in sham-operated rats and in rats with bile duct ligation. 6. The results suggest that obstructive jaundice following bile duct ligation is associated with enhanced renal glomerular thromboxane A2 synthesis, which suppresses glomerular filtration rate and predisposes to acute renal failure. Treatment with Daltroban, a specific thromboxane A2/prostaglandin H2 receptor antagonist, restores glomerular filtration rate to normal, probably secondary to normalization of disturbed intrarenal blood flow following bile duct ligation.

DIAGNOSIS AND TREATMENT: ACUTE RENAL FAILURE

PEDIATRICS ◽  
1965 ◽  
Vol 35 (3) ◽  
pp. 478-481
Author(s):  
Malcolm A. Holliday
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Glomerular Filtration Rate ◽  
Renal Disease ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
Obstructive Uropathy ◽  
Urine Flow ◽  
Water Restriction ◽  
Plasma Electrolyte

ACUTE RENAL FAILURE is an uncommon emergency which faces pediatricians. It is usually easy to recognize. The management in the early phase is critical to the survival potential of the patient. The purpose of this review is to cite the causes, characteristics, and principally the management of acute renal failure. Renal failure is defined as a state in which there is not sufficient kidney function to prevent the development of severe uremia or to maintain plasma electrolyte values in a range compatible with ordinary activities. Clinically the condition is associated with mental confusion, stupor, and frequently convulsions. Persistent hiccoughs, irregular respirations, and muscle cramps also may occur. Usually though not always, there is obvious oliguria. Since urine flow is ordinarily but 0.2-2,0% of glomerular filtration rate, and since glomerular filtration rate reduction to 5-10% may be associated with uremia, it is possible to have renal failure without oliguria. It is also possible to have physiological oliguria (&lt; 300 ml per square meter) in response to rigid water restriction that is not related to renal failure. Hence, the term must be defined in terms of its effect on plasma composition rather than in terms of urine flow. The presence of certain clinical conditions known to result in acute renal failure should alert the physician. These include: nephrotoxie agents; hemoglobinuria or myoglobinuria; shock with anoxic damage; acute, diffuse renal disease; acute dehydration in patients with chronic advanced renal disease; and acute obstructive uropathy. Nephrotoxic agents, hemoglobinuria, and shock all result in acute tubular necrosis, and recovery depends upon the capacity of the nephron to regenerate on an intact basement membrane.

Renal Tubular Protein Degradation of Radiolabelled Aprotinin (Trasylol) in Patients with Chronic Renal Failure

1993 ◽  
Vol 85 (6) ◽  
pp. 733-736 ◽  
Author(s):  
R. Rustom ◽  
J. S. Grime ◽  
P. Maltby ◽  
H. R. Stockdale ◽  
M. J. Jackson ◽  
...  
Keyword(s):  
Renal Failure ◽  
Renal Function ◽  
Glomerular Filtration Rate ◽  
Chronic Renal Failure ◽  
Glomerular Filtration ◽  
Normal Renal Function ◽  
Filtration Rate ◽  
Renal Uptake ◽  
The Mean ◽  
Renal Tubular

1. The new method developed to measure renal tubular degradation of small filtered proteins in patients with normal renal function, using radio-labelled aprotinin (Trasylol) (R. Rustom, J. S. Grime, P. Maltby, H. R. Stockdale, M. Critchley, J. M. Bone. Clin Sci 1992; 83, 289–94), was evaluated in patients with chronic renal failure. 2. Aprotinin was labelled with either 99mTc (40 MBq) or 131I (0.1 MBq), and injected intravenously in nine patients, with different renal pathologies. 51Cr-EDTA clearance (corrected for height and weight) was 40 + 5.4 (range 11.2-81) ml min−1 1.73 m−2. Activity in plasma and urine was measured over 24–48 h, and chromatography on Sephadex-G-25-M was used to separate labelled aprotinin from free 99mTcO4− or 131I−. Renal uptake was measured for 99mTc-labelled aprotinin only. 3. The volume of distribution was 20.2 + 2.3 litres. Chromatography showed all plasma activity as undegraded aprotinin, and urine activity only as the free labels (99mTcO4− or 131I−). 4. As in patients with normal renal function, activity in the kidney appeared promptly, with 5.7 + 2.5% of the dose detected even at 5 min. Activity rose rapidly to 9.4 + 1.6% of dose after 1.5 h, then more slowly to 15.0 + 0.5% of dose at 4.5 h, and even more slowly thereafter, reaching 24.1 + 2.8% of dose at 24 h. Extra-renal uptake was again insignificant, and both 99mTcO4− and 131I− appeared promptly in the urine, with similar and uniform rates of excretion over 24 h. 5. Both tubular uptake at 24 h and the rate of tubular metabolism over 24 h were lower than in the patients with normal renal function studied previously, but only the rate of tubular metabolism was directly related to the glomerular filtration rate (r = 0.75, P <0.02). 6. Correction for the reduced glomerular filtration rate yielded values for both tubular uptake (0.67 + 0.14 versus 0.32 + 0.03% of dose/ml of glomerular filtration rate, P <0.005), and tubular metabolism (0.033 + 0.07 versus 0.015 + 0.001% of dose h−1 ml−1 of glomerular filtration rate, P <0.005) that were higher by comparison with those for patients with normal renal function studied previously. 7. Fractional renal degradation of 99mTc-aprotinin (in h−1), derived from the mean rate of urinary excretion of the free isotope over a given interval, divided by the mean cumulative kidney uptake over the same interval, also fell steeply early, and then more slowly to 0.07 + 0.01 h−1 at 14.25 h (between 4.5 and 24 h). 8. It is concluded that the method described previously is also suitable in patients with chronic renal failure, allowing further research into renal disease progression.

scholarly journals Severity Renal Function Detection through Critical Changes Glomerular Filtration Rate in Hemodialysis Patients

Jurnal NERS ◽  
2017 ◽  
Vol 9 (1) ◽  
pp. 43 ◽  
Author(s):  
Martono Martono ◽  
Satino Satino
Keyword(s):  
Renal Failure ◽  
Renal Function ◽  
Glomerular Filtration Rate ◽  
Glomerular Filtration ◽  
Kidney Function ◽  
Filtration Rate ◽  
Hemodialysis Patients ◽  
Quasi Experimental ◽  
Fi Ltration ◽  
Age And Sex

Introductions: Hemodialysis is often interpreted incorrectly. People assume that the action is an action that will cure the treatment of hemodialysis patients with renal failure after hemodialysis. The purpose of this study was to determine the ability of critical changes in renal glomerular fi ltration rate in patients with hemodialysis nursing care. Method: The design is quasi-experimental study carried out 2 times the observation that pre-test and post-test with a retrospective approach. The study population was all patients who underwent hemodialysis with a sample size of 33 respondents. Analysis of the research data using the paired t test. Result: The results of this study indicate that the glomerular fi ltration rate fi xing Hemodialysis towards better able to detect and prevent the severity of renal function as evidenced by the value of P = 0.031 for change 9.18. Discussion: Hemodialysis fi x glomerular fi ltration rate towards better able to detect and prevent the severity of renal function with the ability to take into account the age and sex and weight stability. All the patients with chronic renal failure in the terminal stage are expected to follow and adhere to regular hemodialysisprogram with regard stabilization weight, age, and sex in order to avoid the severity of kidney function worse.Keyword: Glomerular Filtration Rate, Hemodialysis, Severity of Kidney Function

Understanding Renal Disorders

2012 ◽  
Author(s):  
Debra Ugboma ◽  
Helen Willis
Keyword(s):  
Primary Care ◽  
Chronic Kidney Disease ◽  
Renal Failure ◽  
Renal Function ◽  
Glomerular Filtration Rate ◽  
Kidney Disease ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
Renal Disorders ◽  
Department Of Health

The aim of this chapter is to provide nurses with the knowledge to be able to assess, manage, and care for people with the renal disorders chronic kidney disease (CKD) and acute kidney injury (AKI) in an evidence-based and person-centred way. In recent years, AKI has replaced the term ‘acute renal failure’. The chapter will provide a comprehensive overview of the causes, risk factors, and impact of CKD and AKI, before exploring best practice to deliver care, as well as to prevent further progression of these conditions. Nursing assessments and priorities are highlighted throughout, and further nursing management of some of the symptoms and common health problems associated with CKD and AKI can be found in Chapters 6, 9, 15, and 19, respectively. Chronic kidney disease (CKD) is the gradual and usually permanent loss of some kidney function over time (Department of Health, 2007). In CKD, the damage and decline in renal function usually occurs over years, and in early stages can go undetected (Department of Health, 2005a). CKD has rapidly moved up the healthcare agenda in recent years, primarily because of the links with cardiovascular risk, and with a shift in focus away from the treatment of established renal failure towards the detection and prevention of CKD in primary care (O’Donohue, 2009). Glomerular filtration rate (GFR) is an indicator of renal function and is the rate at which blood flows through, and is ‘filtered’ by, the kidney; a normal GFR is approximately 125 ml/min. CKD is classified into five stages according to an estimated glomerular filtration rate (eGFR) and, in the milder stages, further evidence of renal damage such as proteinuria and haematuria. This classification holds regardless of the underlying cause of kidney damage. The understanding of GFR is pivotal to caring for patients with renal disorders. Monitoring, management, and referral of the patient in the earlier stages of CKD became much clearer following the publication of the National Clinical Guidelines for the Management of Adults with Chronic Kidney Disease in Primary and Secondary Care (NICE, 2008a). Many people with stage 3 CKD, unless they have proteinuria, diabetes, or other comorbidity such as cardiovascular disease, have a good prognosis and can be managed in primary care (Andrews, 2008).

scholarly journals Iohexol Clearance for Determination of Glomerular Filtration Rate in Rats Induced to Acute Renal Failure

PLoS ONE ◽  
2015 ◽  
Vol 10 (4) ◽  
pp. e0123753 ◽  
Author(s):  
Michelle T. Passos ◽  
Sonia K. Nishida ◽  
Niels O. S. Câmara ◽  
Maria Heloisa Shimizu ◽  
Gianna Mastroianni-Kirsztajn
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Glomerular Filtration Rate ◽  
Glomerular Filtration ◽  
Filtration Rate
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