Normal renal function

2018 ◽  
Author(s):  
Aron Chakera ◽  
William G. Herrington ◽  
Christopher A. O’Callaghan
Keyword(s):  
Renal Function ◽  
Urinary Tract ◽  
Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Kidney Function ◽  
Normal Renal Function ◽  
Tubular Function ◽  
Vital Organ ◽  
Multiple Functions ◽  
Kidney Glomerulus

The kidney is a vital organ with multiple functions. Without kidney function, death will occur in a matter of days. Fortunately, several forms of effective renal replacement therapy are available. This chapter gives a concise introduction to basic urinary tract structure, kidney/glomerulus/tubular function and assessment of kidney function.

scholarly journals Continuous Renal Replacement Therapy: A Review

2021 ◽  
Vol 1 (2) ◽  
pp. 63-77
Author(s):  
Mujahidin ◽  
Yasir Teuku ◽  
Dzaky. A. N
Keyword(s):  
Acute Kidney Injury ◽  
Renal Function ◽  
Renal Replacement Therapy ◽  
Continuous Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Organ Failure ◽  
Kidney Function ◽  
Human Body ◽  
Kidney Injury ◽  
Hemodynamic Stability

Kidney is an important organ to maintain hemodynamic stability inside the human body. In patient with acute kidney injury (AKI) there was a decreased kidney function that could interfere hemodynamic stability which can lead to multi organ failure even death. Around 5-10% patients with AKI required renal replacement therapy (RRT) to support their decreased renal function. Continuous renal replacement therapy (CRRT) is one of RRT modality that commonly used for patients with AKI who are hemodynamically unstable or in critically ill conditions.CRRT could divided into 4 mode, slow continuous ultrafiltration (SCUF), continuous veno-venous hemofiltration (CVVH), continuous veno-venous hemodialysis (CVVHD) and continuous veno-venous hemodialfiltration (CVVHDF). CRRT used based on renal and nonrenal indication. Several studies are still trying to prove nonrenal indication of RRT, to ascertain whether CRRT could be used as therapy effectively. Therefore the indication, the mechanism and the comparison of renal replacement therapy are very important to be understood.

scholarly journals Continuous Renal Replacement Therapy: A Review

2020 ◽  
Vol 1 (2) ◽  
pp. 63-77
Author(s):  
Muja Hidin ◽  
Yasir Teuku ◽  
Dzaky.A.N
Keyword(s):  
Acute Kidney Injury ◽  
Renal Function ◽  
Renal Replacement Therapy ◽  
Continuous Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Organ Failure ◽  
Kidney Function ◽  
Human Body ◽  
Kidney Injury ◽  
Hemodynamic Stability

ABSTRACT Kidney is an important organ to maintain hemodynamic stability inside the human body. In patient with acute kidney injury (AKI) there was a decreased kidney function that could interfere hemodynamic stability which can lead to multi organ failure even death. Around 5-10% patients with AKI required renal replacement therapy (RRT) to support their decreased renal function. Continuous renal replacement therapy (CRRT) is one of RRT modality that commonly used for patients with AKI who are hemodynamically unstable or in critically ill conditions. CRRT could divided into 4 mode, slow continuous ultrafiltration (SCUF), continuous veno-venous hemofiltration (CVVH), continuous veno-venous hemodialysis (CVVHD) and continuous veno-venous hemodialfiltration (CVVHDF). CRRT used based on renal and nonrenal indication. Several studies are still trying to prove nonrenal indication of RRT, to ascertain whether CRRT could be used as therapy effectively. Therefore the indication, the mechanism and the comparison of renal replacement therapy are very important to be understood.

Secondary Oxalate Nephropathy: Causes and Clinicopathological Characteristics of a Case Series

Nephron ◽  
2021 ◽  
pp. 1-8
Author(s):  
Shaoshan Liang ◽  
Lijuan Li ◽  
Dacheng Chen ◽  
Dandan Liang ◽  
Feng Xu ◽  
...  
Keyword(s):  
Renal Function ◽  
Renal Replacement Therapy ◽  
Renal Biopsy ◽  
Replacement Therapy ◽  
Case Series ◽  
Common Cause ◽  
Renal Function Recovery ◽  
Function Recovery ◽  
Renal Biopsies ◽  
Oxalate Nephropathy

<b><i>Introduction:</i></b> Secondary oxalate nephropathy (OxN) is associated with a variety of causes and has not been well characterized in Chinese population. To investigate the etiology, clinicopathological features, and outcomes of secondary OxN, we report a case series from a single center in China. <b><i>Methods:</i></b> A retrospective analysis of 68 patients diagnosed with secondary OxN by renal biopsy from January 2013 to February 2019 in Jinling Hospital was performed. <b><i>Results:</i></b> Secondary OxN accounted for 0.23% of the renal biopsies and 2.31% of patients who received renal biopsies due to acute kidney injury (AKI). A total of 49 men and 19 women with an average age of 51.6 ± 11.8 years were enrolled. The most common cause was iatrogenic medication, followed by oxalate-rich diet and industry exposure. Stage 1, 2, and 3 AKI and AKI on chronic kidney disease (ACKD) were found in 4.4, 8.8, 69.1, and 17.6% of the patients, respectively. The peak serum creatinine during hospitalization was 8.62 ± 4.67 mg/dL. The median urinary oxalate excretion was 51.5 (23.2–147.1) mg/24 h. Kidney biopsy showed extensive calcium oxalate crystal deposits with acute tubulointerstitial nephritis. Thirty-four patients (50.0%) required renal replacement therapy. At the end of a follow-up that lasted 8.7 (0.1–72.1) months, 81.0% of patients achieved renal function recovery in 50 (14–432) days. Patients with renal function recovery had a lower rate of ACKD, a higher level of hemoglobin, a lower level of urine lysozyme, and a lower degree of interstitial fibrosis/tubular atrophy, interstitial inflammation, and global glomerulosclerosis than those in the nonrecovery group. <b><i>Conclusions:</i></b> In this case series of secondary OxN, the most common cause was iatrogenic medication, and it presented with AKI or ACKD. Half of the patients required renal replacement therapy, and in most of them, the renal function was reversible. Renal biopsy played an important role in diagnosis and prognosis evaluation.

scholarly journals Multicenter Population Pharmacokinetic Study of Colistimethate Sodium and Colistin Dosed as in Normal Renal Function in Patients on Continuous Renal Replacement Therapy

2018 ◽  
Vol 63 (2) ◽  
pp. e01957-18 ◽  
Author(s):  
Anne B. Leuppi-Taegtmeyer ◽  
Laurent Decosterd ◽  
Michael Osthoff ◽  
Nicolas J. Mueller ◽  
Thierry Buclin ◽  
...  
Keyword(s):  
Renal Function ◽  
Body Weight ◽  
Renal Replacement Therapy ◽  
Continuous Renal Replacement Therapy ◽  
Normal Renal Function ◽  
Maintenance Dose ◽  
Population Pharmacokinetic ◽  
Loading Dose ◽  
Optimal Dosing ◽  
Colistimethate Sodium

ABSTRACT Intravenous colistimethate sodium (CMS) is used to treat infections with multiresistant Gram-negative bacteria. Optimal dosing in patients undergoing continuous renal replacement therapy (CRRT) is unclear. In a prospective study, we determined CMS and colistin pharmacokinetics in 10 critically ill patients requiring CRRT (8 underwent continuous venovenous hemodialysis [CVVHD]; median blood flow, 100 ml/min). Intensive sampling was performed on treatment days 1, 3, and 5 after an intravenous CMS loading dose of 9 million international units (MU) (6 MU if body weight was <60 kg) with a consecutive 3-MU (respectively, 2 MU) maintenance dose at 8 h. CMS and colistin concentrations were determined by liquid chromatography with mass spectroscopy. A model-based population pharmacokinetic analysis incorporating CRRT settings was applied to the observations. Sequential model building indicated a monocompartmental distribution for both CMS and colistin, with interindividual variability in both volume and clearance. Hematocrit was shown to affect the efficacy of drug transfer across the filter. CRRT clearance accounted for, on average, 41% of total CMS and 28% of total colistin clearance, confirming enhanced elimination of colistin compared to normal renal function. Target colistin steady-state trough concentrations of at least 2.5 mg/liter were achieved in all patients receiving 3 MU at 8 h. In conclusion, a loading dose of 9 MU followed after 8 h by a maintenance dose of 3 MU every 8 h independent of body weight is expected to achieve therapeutic colistin concentrations in patients undergoing CVVHD using low blood flows. Colistin therapeutic drug monitoring might help to further ensure optimal dosing in individual patients. (This study has been registered at ClinicalTrials.gov under identifier NCT02081560.)

scholarly journals Erythrocyte Sedimentation Rate in Patients with Renal Insufficiency and Renal Replacement Therapy

2021 ◽  
Author(s):  
Anna Buckenmayer ◽  
Lotte Dahmen ◽  
Joachim Hoyer ◽  
Sahana Kamalanabhaiah ◽  
Christian S. Haas
Keyword(s):  
Renal Function ◽  
Peritoneal Dialysis ◽  
Renal Replacement Therapy ◽  
Kidney Disease ◽  
Renal Insufficiency ◽  
Replacement Therapy ◽  
Sedimentation Rate ◽  
Inflammatory Markers ◽  
Erythrocyte Sedimentation ◽  
Esrd Patients

Abstract Background: The erythrocyte sedimentation rate (ESR) is a simple laboratory diagnostic tool for estimating systemic inflammation. It remains unclear, if renal function affects ESR, thereby compromising its validity. This pilot study aims to compare prevalence and extent of ESR elevations in hospitalized patients with or without kidney disease. In addition, the impact of renal replacement therapy (RRT) modality on ESR was determined.Methods: In this single-center, retrospective study, patients were screened for ESR values. ESR was compared in patients with and without renal disease and/or RRT. In addition, ESR was correlated with other inflammatory markers, the extent of renal insufficiency and clinical characteristics.Results: A total of 203 patients was identified, showing an overall elevated ESR in the study population (mean 51.7±34.6 mm/h). ESR was significantly increased in all patients with severe infection, active vasculitis or cancer, respectively, independent from renal function. Interestingly, there was no difference in ESR between patients with and without kidney disease or those having received a prior renal transplant or being on hemodialysis. However, ESRD patients treated with peritoneal dialysis presented with a significantly higher ESR (78.3±33.1 mm/h, p<0.001), while correlation with other inflammatory markers was not persuasive.Conclusions: We showed that ESR: (1) does not differ between various stages of renal insufficiency; (2) may be helpful as a screening tool also in patients with renal insufficiency; and (3) is significantly increased in ESRD patients on peritoneal dialysis per se, while it seems not to be affected by hemodialysis or renal transplantation (see graphical abstract as supplementary material).

scholarly journals Intermittent Hemodialysis For Patients With Acute Kidney Injury (AKI): Outcome In A Tertiary Level Hospital

2018 ◽  
Vol 17 (1) ◽  
pp. 25-30
Author(s):  
Arun Sharma ◽  
Binod Karki ◽  
Ajay Rajbhandari
Keyword(s):  
Acute Kidney Injury ◽  
Renal Function ◽  
Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Acute Gastroenteritis ◽  
Kidney Injury ◽  
Tertiary Level ◽  
Intermittent Hemodialysis ◽  
The Mean ◽  
Level Hospital

INTRODUCTION: Acute kidney injury (AKI) is the sudden loss of renal function with accumulation of nitrogenous waste compounds. In developing countries, community acquired AKI is common than AKI in hospitalized septic patients. With conservative management many patients recover renal function however few require renal support with intermittent Hemodialysis (HD). We conducted a study to find out the etiology and outcome of the patients presenting with AKI who required dialysis.METHODS: This is a descriptive follow up study of the patients who needed renal replacement therapy in the form of HD presenting to our Nephrology unit of the hospital over a period of two years. Patients were followed up for three months post discharge. Data were tabulated and analyzed using SPSS software.RESULTS: Total 50 patients were included in study with 67% male. The commonest etiologies were urinary tract infection (30%) and  acute gastroenteritis (24%).The mean creatinine at the time of nephrology consultation, maximum level and at the time of discharge were 6.5(SD± 2.62), 7.3(SD ±2.13) and 2.2(SD ±1.75) respectively. Uremia with anuria was the most common reason for the initiation of HD in 54% cases. The mean number of intermittent HD used was 3.36. Complete recovery was seen in 68%, death in 26% and CKD in 6%.CONCLUSION: UTI followed by acute gastroenteritis are the leading cause of AKI in our tertiary level hospital. Timely initiated renal replacement therapy in the form of intermittent HD could lead to substantial renal recovery in almost three fourth of patients.

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