scholarly journals Renal Negative Pressure Treatment as a Novel Therapy for Heart Failure Induced Renal Dysfunction

2021 ◽  
Author(s):  
Veena S Rao ◽  
Christopher Maulion ◽  
Jennifer L Asher ◽  
Juan Betuel Ivey-Miranda ◽  
Zachary L Cox ◽  
...  
Keyword(s):  
Heart Failure ◽  
Negative Pressure ◽  
Renal Plasma Flow ◽  
Venous Pressure ◽  
Fractional Excretion ◽  
Novel Therapy ◽  
Pressure Therapy ◽  
Fractional Excretion Of Sodium ◽  
Renal Tubular ◽  
Iothalamate Clearance

Congestion is the primary pathophysiologic lesion in most heart failure (HF) hospitalizations. Renal congestion increases renal tubular pressure, reducing glomerular filtration rate (GFR) and diuresis. Because each nephron is a fluid filled column, renal negative pressure therapy (rNPT) applied to the urinary collecting system should reduce tubular pressure, potentially improving kidney function. We evaluated the renal response to rNPT in congestive HF. Ten anesthetized ∼80 kg pigs underwent instrumentation with bilateral renal pelvic JuxtaFlow® catheters. GFR was determined by iothalamate clearance (mGFR) and renal plasma flow (RPF) by para-aminohippurate clearance. Each animal served as its own control with randomization of L vs. R kidney to -30mmHg rNPT or no rNPT mGFR and RPF were measured simultaneously from the rNPT and no rNPT kidney. Congestive HF was induced via cardiac tamponade maintaining central venous pressure at 20-22.5mmHg throughout the experiment. Prior to HF induction, rNPT increased natriuresis, diuresis, and mGFR compared with the control kidney (p<0.001 for all). Natriuresis, diuresis, and mGFR, decreased following HF (p<0.001 for all) but were higher in rNPT kidney vs. control (p<0.001 for all). RPF decreased during HF (p<0.001) without significant differences between rNPT treatments. During HF the rNPT kidney had similar diuresis and natriuresis (p>0.5 for both), and higher fractional excretion of sodium (p=0.001) compared with the non-rNPT kidney in the no-HF period. In conclusion, rNPT resulted in significantly increased diuresis, natriuresis, and mGFR, with or without experimental HF. rNPT improved key renal parameters of the congested cardio-renal phenotype.

scholarly journals Nurse Approach in the Treatment of Piabetic Foot Ulcers with the Management of Negative Pressure Therapy

2021 ◽  
pp. 1-4
Author(s):  
Astasio Picado Álvaro ◽  
Keyword(s):  
Negative Pressure ◽  
Diabetic Foot ◽  
Bacterial Load ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
Negative Pressure Therapy ◽  
Novel Therapy ◽  
Pressure Therapy ◽  
Advanced Therapy ◽  
Global Increase

The global increase of Diabetes Mellitus represents serious complications for those who suffer from it, the most frequent complications are diabetic foot ulcers and amputations derived from them. Currently, negative pressure therapy (NPT) is used as an advanced therapy for the treatment of this type of ulcers. This novel therapy promises numerous advantages for the nursing approach to patients with diabetic foot ulcers. Therefore, the objective of this narrative review is to prove the effectiveness of the negative pressure therapy as a treatment for diabetic foot ulcers. The search of the articles was carried out in several scientific databases with the help of a searching chain, which combined the keywords and boolean operators. 16 studies were selected, which indicated that NPT as a treatment for diabetic foot ulcers provides benefits such as promoting the formation of granulation tissue, healing and closing of the ulcer in a shorter time, as well as reducing ulcer depth and area and even decreases the bacterial load, the rate of amputations and reulcerations. Hence, NPT is an effective therapy that should be applied to clinical practice

Effect of vasoactive intestinal peptide on isolated perfused rat kidney

1985 ◽  
Vol 249 (5) ◽  
pp. E494-E497 ◽  
Author(s):  
R. M. Rosa ◽  
P. Silva ◽  
J. S. Stoff ◽  
F. H. Epstein
Keyword(s):  
Vasoactive Intestinal Peptide ◽  
Rat Kidney ◽  
Urine Volume ◽  
Fractional Excretion ◽  
Rectal Gland ◽  
Renal Nerves ◽  
Isolated Perfused Rat Kidney ◽  
Fractional Excretion Of Sodium ◽  
Perfused Rat Kidney ◽  
Renal Tubular

Vasoactive intestinal peptide, a polypeptide neurotransmitter, stimulates salt secretion by the mammalian intestine and the rectal gland of the dogfish shark. Because of the recent identification of vasoactive intestinal peptide in renal nerves, the present study was undertaken to investigate its effects on the isolated perfused rat kidney. The addition of vasoactive intestinal peptide to the recirculating perfusate produced a significant increase in urine volume, fractional excretion of sodium, chloride, and potassium, as well as osmolar clearance when compared with control kidneys. These changes associated with addition of vasoactive intestinal peptide occurred without any significant changes in perfusion flow, renal vascular resistance, or inulin clearance. These experiments strongly suggest an action of vasoactive intestinal peptide on renal tubular reabsorption.

scholarly journals Assessment of Urinary Kidney Injury Molecule-1 as an Indicator of Early Renal Insult in Children with Cystic Fibrosis

2020 ◽  
Vol 8 (B) ◽  
pp. 262-267
Author(s):  
Walaa Shahin ◽  
Ahmed Bader ◽  
Rawdah Ahmed ◽  
Mona Alattar ◽  
Mona Alfalaki ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Urine Analysis ◽  
Kidney Injury ◽  
Fractional Excretion ◽  
Control Group ◽  
Renal Ultrasound ◽  
Fractional Excretion Of Sodium ◽  
Beta 2 ◽  
Renal Tubular ◽  
Kidney Injury Molecule 1

BACKGROUND: The risk of acute kidney injury in cystic fibrosis (CF) patients is due to renal tubular affection by CFTR gene. AIM: Our study aimed at early detection of renal impairment in CF patients, to enable careful monitoring and adjustment of nephrotoxic medications. METHODS: Fifty patients with CF were enrolled in our study; they were age- and sex-matched to 40 healthy control children. All subjects were screened by urine analysis, measurements of kidney function tests, fractional excretion of sodium, β2-microglobulin (beta-2-M) excretion, and renal ultrasound examination. Urinary kidney injury molecule-1 (KIM-1) was assayed using ELISA technique. RESULTS: Both urinary beta-2-M and KIM-1 concentrations were significantly higher in CF patients compared to the control group (p < 0.001). The duration of the disease was significantly positively correlated with the urinary beta-2-M and KIM-1 levels (r = 0.6 and 0.7, respectively; p < 0.01). CONCLUSIONS: Our results showed that urinary KIM-1 can be considered as a sensitive early indicator of acute renal injury.

Tubular function

2015 ◽  
Author(s):  
Marijn Speeckaert ◽  
Joris Delanghe
Keyword(s):  
Fractional Excretion ◽  
Tubular Function ◽  
Tubular Dysfunction ◽  
Renal Fanconi Syndrome ◽  
Glomerular Function ◽  
Diminished Capacity ◽  
Fractional Excretion Of Sodium ◽  
Proximal Tubular ◽  
Pass Through ◽  
Renal Tubular

Assessment of tubular function is more complicated than the measurement of glomerular filtration rate. Different functions may be affecting according to the different segments of tubule involved. Key tests include concentrating and diluting capacity, and fractional excretion of sodium. Tubular proteinuria occurs when glomerular function is normal, but when the proximal tubules have a diminished capacity to reabsorb and to catabolize proteins, causing an increased urinary excretion of the low-molecular-mass proteins that normally pass through the glomerulus. Proximal tubular dysfunction is characterized by hypophosphataemia, and a variety of other abnormalities characteristics of the renal Fanconi syndrome. Distinguishing the location of the lesion in Renal Tubular Acidosis is considered in Chapter 35.

Unimpaired excretion of an acute salt load in conscious hypoproteinaemic dogs

1988 ◽  
Vol 75 (3) ◽  
pp. 271-276 ◽  
Author(s):  
J. A. Joles ◽  
H. A. Koomans ◽  
P. Boer ◽  
E. J. Dorhout Mees
Keyword(s):  
Glomerular Filtration Rate ◽  
Glomerular Filtration ◽  
Plasma Protein ◽  
Filtration Rate ◽  
Renal Plasma Flow ◽  
Isotonic Saline ◽  
Fractional Excretion ◽  
Sodium Reabsorption ◽  
Filtration Fraction ◽  
Fractional Excretion Of Sodium

1. The role of hypoproteinaemia in the sodium retention seen in conditions such as the nephrotic syndrome is incompletely known. 2. To define the influence of severe hypoproteinaemia on kidney function, we studied the effect of an intravenous infusion of an isotonic saline load (133 mmol of sodium), as 1 litre of Ringer lactate solution, on sodium excretion and renal haemodynamics in conscious dogs before and after reduction of plasma protein from 68 ± 3 to 36 ±2 g/l by repeated plasmapheresis and a low protein diet. 3. During hypoproteinaemia, 2 days after a period of plasmapheresis, glomerular filtration rate and effective renal plasma flow were lower than in the control study. After the sodium load, both rose to values nearly identical with the pre-infusion levels found in normoproteinaemia, the filtration fraction remaining unchanged. This contrasted with the rise in filtration fraction after expansion in normoproteinaemia, where filtration fraction increased from 32 to 39% due to a rise in glomerular filtration rate. 4. After expansion, natriuresis rose to similar levels in normoproteinaemia (0.18 ±0.06 mmol/min) and hypoproteinaemia (0.20 ± 0.06 mmol/min), and increments in fractional excretion of sodium, potassium and chloride were also similar. However, baseline excretion was higher in the hypoproteinaemic dogs due to their overhydrated condition in this period immediately after plasmapheresis. 5. The fractional excretion of lithium, an alleged marker of proximal tubular sodium reabsorption, rose to comparable levels. 6. Hence, both the increase in filtration and decrease in reabsorption of sodium after an isotonic saline load are not affected by severe reduction in plasma protein concentration. Apparently, the pathways to augment natriuresis after acute expansion function normally in hypoproteinaemia.

scholarly journals The beneficial effects of thyroxine on nephrotoxic acute renal failure in the rat.

1991 ◽  
Vol 1 (11) ◽  
pp. 1236-1240
Author(s):  
U F Michael ◽  
J L Logan ◽  
L A Meeks
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Potassium Dichromate ◽  
Fractional Excretion ◽  
Repair Process ◽  
Acid Extraction ◽  
Sprague Dawley ◽  
Beneficial Effects ◽  
Fractional Excretion Of Sodium ◽  
Renal Tubular

We were able to confirm previous studies demonstrating that administration of thyroxine is capable of ameliorating the severity of acute nephrotoxic renal failure in the rat. Nephrotoxic acute renal failure was induced by the subcutaneous injection of potassium dichromate (6.25 mg/kg) into Sprague-Dawley rats. Twenty-four hours after this injection, rats received an intraperitoneal injection of either thyroxine (80 micrograms/kg body wt) or normal saline. Forty-eight hours after the potassium dichromate injection, renal clearance studies were performed. Inulin clearance was significantly higher in the thyroxine-treated than in the saline-treated acute renal failure rats: 1.12 +/- 0.13 (SEM) mL/g versus 0.75 +/- 0.07 mL/min/g kidney wt (P = 0.025). Thyroxine treatment also effected an increase of p-aminohippuric acid extraction from 0.23 +/- 0.03 to 0.33 +/- 0.02 (P = 0.011) and a decrease in the fractional excretion of sodium from 0.38 +/- 0.21 to 0.11 +/- 0.03% (P = 0.037 by Mann-Whitney U test). In order to investigate one potential mechanism of the beneficial effect of thyroxine we studied renal tubular regeneration in this model of acute renal failure. Renal cortical uptake of labeled thymidine into DNA was significantly increased 48 h after the injection of potassium dichromate, and thyroxine administration further enhanced this repair process: 53.9 +/- 3.6 versus 81.4 +/- 5.3 dpm/200 pg of DNA (P = 0.0033).

scholarly journals Nurse Approach in the Treatment of Piabetic Foot Ulcers with the Management of Negative Pressure Therapy

2021 ◽  
pp. 1-4
Author(s):  
Astasio Picado Álvaro ◽  
Keyword(s):  
Negative Pressure ◽  
Diabetic Foot ◽  
Bacterial Load ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
Negative Pressure Therapy ◽  
Novel Therapy ◽  
Pressure Therapy ◽  
Advanced Therapy ◽  
Global Increase

The global increase of Diabetes Mellitus represents serious complications for those who suffer from it, the most frequent complications are diabetic foot ulcers and amputations derived from them. Currently, negative pressure therapy (NPT) is used as an advanced therapy for the treatment of this type of ulcers. This novel therapy promises numerous advantages for the nursing approach to patients with diabetic foot ulcers. Therefore, the objective of this narrative review is to prove the effectiveness of the negative pressure therapy as a treatment for diabetic foot ulcers. The search of the articles was carried out in several scientific databases with the help of a searching chain, which combined the keywords and boolean operators. 16 studies were selected, which indicated that NPT as a treatment for diabetic foot ulcers provides benefits such as promoting the formation of granulation tissue, healing and closing of the ulcer in a shorter time, as well as reducing ulcer depth and area and even decreases the bacterial load, the rate of amputations and reulcerations. Hence, NPT is an effective therapy that should be applied to clinical practice

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