The Effects of Chronic Unilateral Renal Artery Constriction on Blood Pressure, Separate Renal Function, and the Development of Collateral Circulation in the Dog

1972 ◽  
Vol 50 (12) ◽  
pp. 1170-1180 ◽  
Author(s):  
S. M. Zweig ◽  
A. Rapoport ◽  
D. R. Wilson ◽  
G. N. Ranking ◽  
H. Husdan
Keyword(s):  
Renal Function ◽  
Renal Artery ◽  
Collateral Circulation ◽  
Sodium Concentration ◽  
Aortic Pressure ◽  
Creatinine Concentration ◽  
Chloride Excretion ◽  
Renal Vascular ◽  
Two Sides ◽  
Renal Artery Constriction

In 10 dogs in each of which one kidney was left intact, unilateral renal artery constriction (R.A.C.) resulted in an increase in aortic pressure (PA) for as long as 13 months. When PA had stabilized at 156 ± 14 mm Hg compared with a baseline of 128 ± 13 mm Hg (p < 0.001) urine flow rate (V), sodium excretion (UNaV), and chloride excretion (UClV) decreased in the constricted kidney (E), while creatinine clearance (CCr) and para-aminohippurate clearance (CPAH) did not change significantly. In the contralateral control kidney (C) V, UNaV, and UClV increased, in association with increases in CCr and CPAH, but without changes in filtration fraction or renal vascular resistance. Although E/C creatinine concentration (UCr) increased as E/C V fell, E/C urine sodium concentration remained unchanged. However, when differences in V, UNaV, UClV, CCr, CPAH, and UCr between C and E were enhanced in relation to a transient exaggerated increase in PA in the acute phase following R.A.C., E/C UNa appeared to decrease slightly. When collateral circulation which had developed to E was stripped, enhanced differences in separate renal function recurred in association with a further increase in PA. Thus, chronic R.A.C. leads to the development of collateral renal circulation which appears responsible for improvement in function in E, and decrease in PA. These effects are associated with decrease in function on the control side, thereby leading to a reduction in differences in function between the two sides.

scholarly journals Prediction of renal dysfunction in patients with obstructive icterus

2011 ◽  
Vol 64 (9-10) ◽  
pp. 503-506 ◽  
Author(s):  
Suzana Raicevic-Sibinovic ◽  
Aleksandar Nagorni ◽  
Vesna Brzacki ◽  
Mirjana Radisavljevic
Keyword(s):  
Renal Function ◽  
Renal Dysfunction ◽  
Concentration Index ◽  
Surgical Intervention ◽  
Urine Osmolality ◽  
Sodium Concentration ◽  
Control Group ◽  
Osmotic Concentration ◽  
Creatinine Concentration ◽  
Urinary Osmolality

Introduction. Renal dysfunction is one of complications in patients with obstructive icterus. It is important to recognize it early and take adequate measure to prevent its occurrence. One third of the patients with obstructive icterus have deterioration of renal function before surgical intervention. The aim of the research was to assess the renal dysfunction markers in patients with obstructive icterus. The following factors were examined: diuresis, urinary sodium concentration, sodium excretory fraction, urine osmolality, osmotic concentration index, creatinine concentration index and renal index of lesion. Material and methods. The study included 85 patients with obstructive icterus (50 patients before surgical intervention and 35 after surgical intervention) and 30 patients without icterus as a control group. The patients with normal renal function before the development of the disease were included. Results. Malignant etiology was present in 39 patients and benign in 46 patients of the examined group. The evaluation parameters of renal function were examined in all of the patients. Creatinine concentration index led to the greatest change in the coefficient value of an internal consistency, showing that it was the best renal function marker in the examined group of patients with icterus. The next one was the urinary osmolality, since its exclusion would lead to a decrease in the value of Cronbach ? coefficient to 0.06. Icterus and surgical intervention show statistically significant effects to change in the value of the markers of laboratory differentiation of renal function, observed as an entire set. Discussion and conclusion. The examination showed that the concentration clearances of creatinine and urine osmolality are the parameters which point to the probability of renal dysfunction occurrence in obstructive icterus.

Contralateral Renal Function Following Unilateral Renal Artery Constriction

1982 ◽  
Vol 5 (6) ◽  
pp. 297-305
Author(s):  
Robert D. Murray ◽  
Eberhard Hackenthal ◽  
Ulrich Mittmann ◽  
Franz Gross
Keyword(s):  
Renal Function ◽  
Renal Artery ◽  
Renal Artery Constriction

scholarly journals Long-Term Effects of Arterial Stenting on Kidney Functionfor Patients with Ostial Atherosclerotic Renal Artery Stenosis and Renal Insufficiency

2001 ◽  
Vol 12 (7) ◽  
pp. 1475-1481
Author(s):  
JAAP J. BEUTLER ◽  
JACOBINE M. A. VAN AMPTING ◽  
PETER J. G. VAN DE VEN ◽  
HEIN A. KOOMANS ◽  
FREDERIK J. A. BEEK ◽  
...  
Keyword(s):  
Renal Failure ◽  
Renal Function ◽  
Serum Creatinine ◽  
Renal Artery ◽  
Renal Artery Stenosis ◽  
Stent Placement ◽  
Serum Creatinine Concentration ◽  
Atherosclerotic Renal Artery Stenosis ◽  
Creatinine Concentration

Abstract. It is uncertain whether renal artery stent placement in patients with atherosclerotic renovascular renal failure can prevent further deterioration of renal function. Therefore, the effects of renal artery stent placement, followed by patency surveillance, were prospectively studied in 63 patients with ostial atherosclerotic renal artery stenosis and renal dysfunction (i.e., serum creatinine concentrations of >120 μmol/L (median serum creatinine concentration, 171 μmol/L; serum creatinine concentration range, 121 to 650 μmol/L). Pre-stent renal (dys) function was stable for 28 patients and declining for 35 patients (defined as a serum creatinine concentration increase of ≥20% in 12 mo). The median follow-up period was 23 mo (interquartile range, 13 to 29 mo). Angioplasty to treat restenosis was performed in 12 cases. Five patients reached end-stage renal failure within 6 mo, and this was related to stent placement in two cases. Two other patients died or were lost to follow-up monitoring within 6 mo, with stable renal function. For the remaining 56 patients, the treatment had no effect on serum creatinine levels if function had previously been stable; if function had been declining, median serum creatinine concentrations improved in the first 1 yr [from 182 μmol/L (135 to 270 μmol/L) to 154 μmol/L (127 to 225 μmol/L); P < 0.05] and remained stable during further follow-up monitoring. In conclusion, stent placement, followed by patency surveillance, to treat ostial atherosclerotic renal artery stenosis can stabilize declining renal function. For patients with stable renal dysfunction, the usefulness is less clear. The possible advantages must be weighed against the risk of renal failure advancement with stent placement.

Local effect of serotonin on renal vascular resistance and urine flow rate

1959 ◽  
Vol 196 (5) ◽  
pp. 1122-1126 ◽  
Author(s):  
D. A. Emanuel ◽  
J. Scott ◽  
R. Collins ◽  
F. J. Haddy
Keyword(s):  
Renal Artery ◽  
Vascular Resistance ◽  
Flow Rate ◽  
Blood Flow Rate ◽  
Aortic Pressure ◽  
Local Effect ◽  
Urine Flow ◽  
Renal Vascular Resistance ◽  
Urine Flow Rate ◽  
Renal Vascular

The effect of serotonin upon renal vascular resistance and urine flow rate when infused directly into the renal artery was studied in 37 laparotomized anesthetized dogs. Concentrations of 10 and 100 µg/min. were utilized in kidneys that were innervated, denervated and denervated plus infused with a sympatholytic and adrenolytic agent. In one series, blood flow rate was maintained constant with a pump interposed in the renal artery. Pressures were measured in the renal artery and vein. Changes in renal vascular resistance in nerve intact, denervated and denervated phentolaminized kidneys were +0.14 ± 0.14, +0.16 ± 0.11 and +0.09 ± 0.07 mm Hg/ml/min. Urine flow rate did not change. In a second series, urine flow rate and aortic pressure were measured without the blood pump. Urine flow rate changes for intact, denervated and denervated phentolaminized kidneys were –0.30 ± 0.43, –0.06 ± 0.44 and 0.00 ± 0.37 ml/min. Aortic pressure remained constant. These data indicate that the local effect of serotonin in the amount used is to actively increase the geometric component of renal vascular resistance through some mechanism unrelated to extrinsic nerves and circulating or locally released catecholamines. Under the conditions of the study, regular changes in urine flow rate were not observed.

Effect of Suprarenal Fixation of Aortic Stent-Grafts on the Renal Artery Ostia: Assessment of Morphological Changes by Virtual Intravascular Endoscopy

2007 ◽  
Vol 14 (5) ◽  
pp. 650-660 ◽  
Author(s):  
Zhonghua Sun ◽  
Mark E. O'Donnell ◽  
R. John Winder ◽  
Peter K. Ellis ◽  
Paul H. Blair
Keyword(s):  
Renal Function ◽  
Renal Artery ◽  
Direct Relationship ◽  
Morphological Changes ◽  
Stent Grafts ◽  
Creatinine Concentration ◽  
Stent Grafting ◽  
Dimensional Changes ◽  
Computed Tomographic

Purpose: To investigate the morphological effects of suprarenal fixation of aortic stent-grafts on the renal artery ostia (RaO) by analysis of suprarenal stent wire distribution and vascular calcification across the RaO using virtual intravascular endoscopy (VIE). Methods: Fourteen consecutive patients (11 men; mean age 75 years) from a single institution were studied following endovascular aortic aneurysm repair (EVAR) using the Zenith endograft system from September 1999 to March 2002. Imaging assessment included computed tomographic (CT) measurement of renal artery intraluminal ostial diameter and quantification and analysis of uncovered stent struts across the RaO and radiological determination of RaO calcification. Morphological changes following EVAR at 3 time points (before and within 1 week after stent-grafting, and at the most recent follow-up) were compared for each patient to determine whether suprarenal stent struts or RaO calcification affected intraluminal ostial diameter. Renal function was assessed by temporal measurements of serum creatinine concentration and creatinine clearance. Results: The renal ostium was distorted to variable degrees in all cases at a mean follow-up of 41±6.6 months. An increase in ostial diameter was identified in most patients if the right RaO was calcified when comparing the 1-week postoperative and most recent follow-up CT images (p<0.05). There was no direct relationship between the number of stent struts crossing the RaO and the morphological/dimensional changes (p>0.05). Renal function was not significantly affected. Conclusion: Patients undergoing suprarenal fixation of aortic stent-grafts experienced morphological changes of the RaO to a variable extent at midterm follow-up. Although the presence of stent struts did not significantly affect dimensional changes, we observed that calcification at the renal artery ostium may influence the development of atherosclerotic effects as a direct relationship between the calcification and ostial diameter. Future studies utilizing VIE to determine the long-term safety of this technique in these particular patients requires investigation.

Urinary Beta-Thromboglobulin Correlates with Impairment of Renal Function in Patients with Diabetic Nephropathy

1986 ◽  
Vol 56 (02) ◽  
pp. 229-231 ◽  
Author(s):  
A H Hopper ◽  
H Tindall ◽  
J A Davies
Keyword(s):  
Renal Function ◽  
Diabetic Nephropathy ◽  
Microvascular Disease ◽  
Normal Subjects ◽  
Specific Protein ◽  
Creatinine Concentration ◽  
Β2 Microglobulin ◽  
Plasma Creatinine Concentration ◽  
Insulin Dependent ◽  
Indium 111

SummaryTBeta-thromboglobulin (βTG) is a platelet-specific protein and since its concentration in plasma rises when platelets are activated, it has been used as an indicator of platelet involvement in vascular disease. Since platelets might be involved in the pathogenesis of diabetic microvascular disease we measured urinary βTG in 20 insulin-dependent diabetics with nephropathy and compared the results with those from 20 normal subjects. Measurement of βTG in urine was undertaken to avoid errors induced by blood sampling and to gain information over a prolonged period using a single assay. Measurements were made of βTG, β2-microglobulin and total protein in urine collected for 24 h and creatinine and β2 microglobulin in plasma. Survival of indium-111-labelled platelets was measured in nine patients. Urinary PTG was significantly (p <0.02) increased in the 20 patients compared with 20 normal volunteers (median value 1.3 vs 0.8 μg/24 h). There was a strong correlation between urinary βTG excretion and plasma creatinine concentration (r = 0.8, p <0.0001) and plasma β2-microglobulin concentration (r = 0.9, p <0.0001). Urinary βTG concentration did not correlate with platelet survival. The results indicate that although urinary βTG is significantly increased in patients with diabetic nephropathy its concentration in urine correlates with indicators of glomerular filtration rather than with a test of platelet activation.

The Significance of Renal Function in Response to Cardiac Resynchronisation Therapy – The Piece of a Much Larger Puzzle

2020 ◽  
Vol 18 ◽  
Author(s):  
Agnieszka Dębska-Kozłowska ◽  
Izabela Warchoł ◽  
Marcin Książczyk ◽  
Andrzej Lubiński
Keyword(s):  
Renal Function ◽  
Nyha Class ◽  
Heart Association ◽  
Cardiac Resynchronisation Therapy ◽  
Study Groups ◽  
Creatinine Concentration ◽  
Significant Difference ◽  
Cardiac Resynchronisation ◽  
Resynchronisation Therapy

Background: Although cardiac resynchronisation therapy (CRT) is an important player in the treatment of heart failure (HF) patients, the proportion of CRT patients with no improvement in either echocardiographic or clinical parameters remains consistently high and accounts for about 30% despite meeting CRT implantation criteria. Furthermore, in patients suffering from HF, renal dysfunction accounts for as many as 30-60%. Accordingly, CRT may improve renal function inducing a systemic haemodynamic benefit leading to increased renal blood flow. Objectives: The aim of the present study was to evaluate the importance of renal function in response to resynchronisation therapy during a 12-month follow-up period. Materials and methods: The study consisted of 46 HF patients qualified for implantation of cardiac resynchronisation therapy defibrillator (CRT-D). A CRT responder is defined as a person without chronic HF exacerbations during observation whose physical efficiency has improved owing to New York Heart Association (NYHA) class improvement ≥1. Results: A statistically significant difference was noted between responders and non-responders regarding creatinine level at the 3rd month (p=0.04) and, particularly, at the 12th month (p=0.02) of follow-up (100±23 vs 139±78 μmol/l). Moreover, there was a remarkable difference between both study groups with regard to GFR CKD-EPI (glomerular filtration rate (GFR) assessed using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) formula) at the 6th (p=0.03) and 12th month (p=0.01) of follow-up. The reference values for initial creatinine concentrations (101 μmol/l) as well as GFR CKD-EPI (63 ml/min/1.73m2 ) were empirically evaluated to predict favourable therapeutic CRT response. Conclusions: Predictive value of GFR CKD-EPI and creatinine concentration for a positive response to CRT were found relevant.

Apresentação e Evolução Atípicas da Granulomatose de Wegener: Relato de Caso/Atypical Presentation and Evolution of Wegener's Granulomatosis: Case Report

1970 ◽  
Vol 5 (3) ◽  
pp. 53-67
Author(s):  
Aline Dos Santos ◽  
Ana Caroline Balducci Scafi ◽  
Luciene Azevedo Morais ◽  
Pablo Girardelli Mendonça Mesquita
Keyword(s):  
Renal Failure ◽  
Renal Function ◽  
Case Report ◽  
Chronic Renal Failure ◽  
Early Diagnosis ◽  
Wegener’S Granulomatosis ◽  
Immunosuppressive Treatment ◽  
Clinical Manifestations ◽  
Wegener's Granulomatosis ◽  
Creatinine Concentration

RESUMOIntrodução: A Granulomatose de Wegener (GW) é uma vasculite rara e idiopática associada à presença do anticorpo Anticitoplasma de Neutrófilo (ANCA) que acomete, preferencialmente, os pequenos vasos. As manifestações clínicas são diversas, ocorrendo em mais de 90% dos casos, sintomas do trato respiratório. O comprometimento renal é tardio e preditor de mau prognóstico.  Sua morbidade a médio e longo prazo inclui insuficiência renal crônica. A probabilidade de sucesso de manutenção da função renal depende da concentração sérica de creatinina ao início do tratamento, o que indica a importância do diagnóstico e terapêutica adequada precoces. Casuística: Relata-se o caso de uma paciente do sexo feminino, 61 anos, portadora de GW com comprometimento renal avançado à apresentação não precedido por sintomas pulmonares esperados. O tratamento imunossupressor associado a plasmaferese permitiu a melhora da função renal da paciente poupando-a de tornar-se dialítica- dependente. Discussão: A paciente iniciou a doença através de insuficiência renal assintomática, com valores de função renal compatíveis com o estágio mais avançado de doença renal crônica, ultrassonografia dos rins sem alterações compatíveis e sem os sintomas respiratórios esperados. Segundo a literatura, a combinação de imunossupressores e plasmaferese associa-se à recuperação renal em três meses com sobrevivência sem necessidade de diálise por 12 meses, no caso relatado, obteve-se tal resultado em 22 dias sem a necessidade de diálise após um ano. Conclusão: Devido ao diagnóstico precoce, o tratamento adequado foi instalado rapidamente proporcionando à paciente um aumento da expectativa e da qualidade de vida, evitando dependência de terapia renal substitutiva.Palavras-Chave: Granulomatose de Wegener, Plasmaferese, Doença renal crônica.  ABSTRACTIntroduction: The Wegener's Granulomatosis (WG) is a rare and idiopathic vasculitis associated with the presence of Antineutrophil Cytoplasmic Antibody (ANCA), that affects, preferentially, the small vessels. The clinical manifestations are diverse, occurring in over 90% of cases, symptoms in the respiratory tract. Kidney damage is a late and bad prognostic predictor. Morbidity in the medium and long term includes chronic renal failure. The probability of renal function maintenance success depends on serum creatinine concentration at the beginning of treatment that indicates the importance of early diagnosis and deployment of an appropriate therapy. Case Report: We present a case of a 61-year-old female patient, carrier of GW with advanced renal impairment presentation, not preceded by expected pulmonary symptoms. The immunosuppressive treatment associated with plasmapheresis allowed the improvement of the patient’s renal function, saving her from becoming dialysis-dependent Discussion: The patient developed the disease through asymptomatic renal failure, renal function with values that are compatible with the most advanced stage of chronic kidney disease, ultrasound of the kidneys without compatible changes and without the expected respiratory symptoms. According to the literature, the combination of immunosuppressive drugs and plasmapheresis is associated with renal recovery in three months with survival without dialysis for 12 months. In this case, a result was obtained in 22 days without the need for dialysis after one year. Conclusion: Due to the early diagnosis, appropriate treatment was quickly installed giving the patient increased life expectancy and quality, preventing dependence on renal replacement therapy.Keywords: Wegener’s granulomatosis, Plasmapheresis, Chronic renal failure.

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