Systemic hemodynamics and renal function in hemorrhaged  dogs resuscitated with cross-linked hemoglobin

Cross-linked hemoglobin (XL-Hb) infused into dogs increases mean arterial pressure (MAP) but decreases blood flow to the renal (RBF), mesenteric (MBF), and iliac (IBF) circulations. These actions differ markedly from dextran infusion (which increases RBF, MBF, and IBF without altering MAP) and may be due to scavenging of nitric oxide by XL-Hb. However, because the hormonal milieu regulating regional circulation is altered during hemorrhage (when XL-Hb may be used), we studied whether systemic hemodynamics, RBF, MBF, IBF, and renal excretory function in hemorrhaged dogs was altered when resuscitated with XL-Hb compared with dextran ( n = 6 each). Hemorrhage decreased MAP by 25% due to a 75% decline in cardiac output. RBF, MBF, and IBF all fell by 33, 64, and 72%, respectively ( P < 0.05 each). There was also a fall in glomerular filtration rate (GFR), urinary flow, and sodium excretion ( P < 0.05 each). After resuscitation, MAP, cardiac output, RBF, MBF, IBF, and GFR all recovered to basal values with either XL-Hb or dextran. Urinary flow and sodium excretion increased to above basal levels with dextran (both by 3.5-fold; P < 0.05) or XL-Hb (by 7.5- and 10-fold, respectively; P < 0.05). We conclude that resuscitation with XL-Hb after hemorrhage not only increases MAP, but also restores RBF, MBF, IBF, GFR, and urinary sodium and volume excretion analogously to dextran. The results contrast with those in normal dogs and suggest that nitric oxide inhibition does not impair hemodynamic and renal function recovery during hemorrhage.

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Nitric oxide (NO) is associated with gentamicin (GENTA) nephrotoxicity and the renal function recovery after suspension of GENTA treatment in rats

Nitric Oxide ◽

10.1016/j.niox.2010.12.001 ◽

2011 ◽

Vol 24 (2) ◽

pp. 77-83 ◽

Cited By ~ 25

Author(s):

Joelma Santina Christo ◽

Adelson Marçal Rodrigues ◽

Margaret Gori Mouro ◽

Marcos Antonio Cenedeze ◽

Manuel de Jesus Simões ◽

...

Keyword(s):

Nitric Oxide ◽

Renal Function ◽

Renal Function Recovery ◽

Function Recovery

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

Nephron ◽

10.1159/000517072 ◽

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

Introduction: 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. Methods: A retrospective analysis of 68 patients diagnosed with secondary OxN by renal biopsy from January 2013 to February 2019 in Jinling Hospital was performed. Results: 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. Conclusions: 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.

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Acute Kidney Injury After Liver, Heart, and Lung Transplants: Dialysis Modality, Predictors of Renal Function Recovery, and Impact on Survival

Advances in Chronic Kidney Disease ◽

10.1053/j.ackd.2009.04.002 ◽

2009 ◽

Vol 16 (4) ◽

pp. 256-267 ◽

Cited By ~ 28

Author(s):

Phuong-Thu T. Pham ◽

Carmen Slavov ◽

Phuong-Chi T. Pham

Keyword(s):

Acute Kidney Injury ◽

Renal Function ◽

Kidney Injury ◽

Dialysis Modality ◽

Renal Function Recovery ◽

Function Recovery ◽

Impact On Survival ◽

Lung Transplants

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Renal Function Recovery and Maintenance of Residual Diuresis in CAPD and Hemodialysis

Peritoneal Dialysis International ◽

10.1177/089686088600600209 ◽

1986 ◽

Vol 6 (2) ◽

pp. 77-79 ◽

Cited By ~ 48

Author(s):

Giovanni C. Cancarini ◽

Giuliano Brunori ◽

Corrado Camerini Silvia ◽

Brasa Luigi Manili ◽

Rosario Maiorca

Keyword(s):

Renal Function ◽

Creatinine Clearance ◽

Residual Renal Function ◽

Significant Drop ◽

Renal Function Recovery ◽

Slow Decline ◽

Function Recovery ◽

Interstitial Nephropathy ◽

One Year

During 1981–1984, at our center 6/75 patients on CAPD and 1/86 on HD demonstrated a recovery of renal function. This and the observation that diuresis was maintained on CAPD, led us to study urine output (UO) and creatinine clearance (CrCI) in 41 patients on CAPD (CAPDp) and 45 on HD (HDp) without the use of diuretics. CAPDp had a decline in diuresis from 1201 ± 379 mI/day to 731 ± 572 (p < 0.01). HDp diuresis decreased from 1233 ± 439 to 438 ± 568 (p < 0.01). Creatinine clearance: HDp 5.8 ± 1.6 ml/min before, 1.3 ± 1.5 after; CAPDp 6.4 ± 2.0 before, 3.9 ± 2.9 after. After one year, HDp showed a significant drop in diuresis; three years passed before CAPDp had significant drop. Patients with glomerulonephritis showed the same trend on HD and CAPD. CAPDp with interstitial nephropathy had a smaller mean annual decrease in UO and CrCI, compared to HDp. CAPDp with nephroangiosclerosis showed less decrease in diuresis compared to HDp. These data confirm that, com pared to HD, CAPD treatment maintains residual renal function even in patients not using diuretics, and suggest that CAPD is a treatment of choice for those considered likely to recover renal function. Some workers have reported a slow decline in residual renal function and diuresis in patients on CAPD (1,2,3). Rottembourg (1), in particular, suggests that diuretics may have helped his patients to maintain diuresis. In 161 dialyzed patients (75 on CAPD, 86 on HD) who started dialysis between 1981 and 1984, six CAPD patients recovered renal function but only one HD patient. This disparity led us to inquire whether when compared to HD, CAPO enables us to maintain satisfactory, long-term diuresis, without the use of diuretics.

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Renal Function Recovery in Chronic Dialysis Patients

Seminars in Dialysis ◽

10.1111/j.1525-139x.2010.00769.x ◽

2010 ◽

Vol 23 (6) ◽

pp. 606-613 ◽

Cited By ~ 16

Author(s):

Jay K. Chu ◽

Vaughn W. Folkert

Keyword(s):

Renal Function ◽

Chronic Dialysis ◽

Dialysis Patients ◽

Renal Function Recovery ◽

Function Recovery

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Hemodynamic and renal effects of cross-linked hemoglobin infusion

AJP Regulatory Integrative and Comparative Physiology ◽

10.1152/ajpregu.1997.272.3.r793 ◽

1997 ◽

Vol 272 (3) ◽

pp. R793-R799 ◽

Cited By ~ 1

Author(s):

A. Cases ◽

J. M. Stulak ◽

Z. Katusic ◽

E. Villa ◽

J. C. Romero

Keyword(s):

Blood Flow ◽

Renal Function ◽

Sodium Excretion ◽

Calcium Ionophore ◽

Urinary Flow ◽

Binding Effect ◽

Scavenging Effect ◽

Before And After ◽

Vascular Beds

It is well known that hemoglobin binds nitric oxide (NO) and produces a pronounced vasoconstriction in isolated arteries. However, it is debatable whether such an effect takes place in whole animals, because hemoglobin also catalyzes the formation of prostaglandins from arachidonic acid. Short-term studies were performed to evaluate the effects induced by intravenous infusion of cross-linked hemoglobin (XL-Hb) on blood pressure (BP) and renal, iliac, and mesenteric flows, and on renal function in six anesthetized dogs. A similar volume-matched expansion with 6% dextran was used as a control (n = 6). Glomerular filtration rate (GFR), urinary flow, and total and fractional sodium excretion were measured before and after XL-Hb or dextran infusion to evaluate possible renal function changes. XL-Hb administration resulted in a 29% elevation in BP and a significant decrease of blood flow (30-37%) to the three vascular beds. XL-Hb did not alter GFR or sodium excretion, despite the increase in BP. In contrast, the administration of dextran did not significantly alter BP but induced a significant increase (6-13%) of blood flow in the three vascular beds. These changes were accompanied by threefold increases in urinary flow and sodium excretion without alterations in GFR. The binding effect of XL-Hb on NO was studied in isolated renal arteries in organ chambers. These in vitro studies showed that XL-Hb blunted the endothelium-mediated vasodilator response to calcium ionophore A-23187 and to acetylcholine. Our results demonstrate that XL-Hb administration is followed by hypertension, vasoconstriction, and blunted natriuresis. All these effects are compatible with the scavenging effect on NO attributed to XL-Hb.

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Recovery of renal function in patients with lupus nephritis and reduced renal function: the beneficial effect of hydroxychloroquine

Lupus ◽

10.1177/0961203319890007 ◽

2019 ◽

Vol 29 (1) ◽

pp. 52-57 ◽

Cited By ~ 4

Author(s):

J S Lee ◽

J S Oh ◽

Y-G Kim ◽

C-K Lee ◽

B Yoo ◽

...

Keyword(s):

Renal Function ◽

Lupus Nephritis ◽

Renal Outcome ◽

Lower Probability ◽

Related Factors ◽

Tubular Atrophy ◽

Renal Function Recovery ◽

Function Recovery ◽

Baseline Renal Function ◽

Reduced Renal Function

Background Reduced renal function is associated with worse renal outcome in patients with lupus nephritis (LN). However, there is insufficient knowledge regarding renal function recovery in patients with LN with reduced baseline renal function. Therefore, the present study aimed to investigate renal function recovery and related factors in patients with reduced baseline renal function. Methods The present retrospective longitudinal cohort study included patients with LN and reduced renal function. Reduced renal function was defined as an estimated glomerular filtration rate (eGFR) of <60 mL/min/1.73 m2. Recovery of renal function was determined by an eGFR of >60 mL/min/1.73 m2 at six months after baseline, and factors associated with it were evaluated using logistic regression analysis. Results We included 90 patients with LN, with a mean eGFR value of 37.2 ± 13.9 mL/min/1.73 m2. Forty-six (51.1%) patients recovered their renal function after six months. On multivariate analysis, hydroxychloroquine use (odds ratio (OR) = 3.891, 95% confidence interval (CI) 1.196–12.653, p = 0.024), prolonged LN (OR = 0.926, 95% CI 0.874–0.981, p = 0.009) and high-grade tubular atrophy (OR = 0.451, 95% CI 0.208–0.829, p = 0.013) were associated with renal function recovery. During follow up, 25 patients were on end-stage renal disease (ESRD). Kaplan–Meier analysis revealed that renal function recovery after six months and lower probability of ESRD are associated. Conclusions In patients with LN and reduced renal function, renal function recovery at six months was associated with use of hydroxychloroquine and inversely related to longer duration of LN and higher grade of tubular atrophy.

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Ambulatory Peritoneal Dialysis: A Study of National Capd Registry Data

Peritoneal Dialysis International ◽

10.1177/089686089201200110 ◽

1992 ◽

Vol 12 (1) ◽

pp. 43-47 ◽

Cited By ~ 10

Author(s):

Anne S. Lindblad ◽

Karl D. Nolph

Keyword(s):

Renal Function ◽

Peritoneal Dialysis ◽

Median Time ◽

Cox Model ◽

Renal Involvement ◽

Renal Infarction ◽

Diabetic Glomerulosclerosis ◽

Recovery Rates ◽

Renal Function Recovery ◽

Function Recovery

From January 1981 to July 1988, the U.S. National CAPD Registry followed 23,771 patients on CAPD or CCPD for 3 months or more in 498 participating centers. Of these patients, 281 were deemed to have enough recovery of renal function to do without dialysis for at least 3 months. The median time on PD before recovery was 126 days in 138 patients treated only by PD from the start of dialysis. The median time to recovery in 106 patients was 238 days from the start of any chronic dialysis. A Cox model analysis revealed significantly (p<0.05) increased chances for renal function recovery in patients with systemic immunological diseases with renal involvement (relative risk for recovery [rr]=2.48), patients with renal infarction related to renal vascular occlusion (rr=4.13), and patients >60 years of age compared to a younger group (rr=1.72). However, patients >60 and <21 experienced similar recovery rates. Reduced chances (p<0.05) for recovery were associated with diabetic glomerulosclerosis (rr=0.25) and polycystic kidney disease (rr=0.13). These findings show that renal function recovery rates in chronic hemodialysis and chronic peritoneal dialysis cannot be properly compared unless all risk factors (favoring or against recovery) are balanced, as in a prospective randomized trial.

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