scholarly journals Intraoperative Fluid Excess Is a Risk Factor for Pancreatic Fistula after Partial Pancreaticoduodenectomy

HPB Surgery ◽  
2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Helge Bruns ◽  
Veronika Kortendieck ◽  
Hans-Rudolf Raab ◽  
Dalibor Antolovic
Keyword(s):  
Renal Function ◽  
Risk Factor ◽  
Filtration Rate ◽  
Roc Analysis ◽  
Fluid Management ◽  
The Other ◽  
Laboratory Findings ◽  
Pancreatic Fistulas ◽  
Partial Pancreaticoduodenectomy ◽  
First Time

Background. After pancreaticoduodenectomy (PD), pancreatic fistulas (PF) are a frequent complication. Infusions may compromise anastomotic integrity. This retrospective analysis evaluated associations between intraoperative fluid excess and PF. Methods. Data on perioperative parameters including age, sex, laboratory findings, histology, infusions, surgery time, and occurrence of grade B/C PF was collected from all PD with pancreaticojejunostomy (PJ) performed in our department from 12/2011 till 02/2015. The glomerular filtration rate (GFR), infusion rate, and the ratio of both and its association with PF were calculated. ROC analysis was employed to identify a threshold. Results. Complete datasets were available for 83 of 86 consecutive cases. Median age was 66 years (34–84; 60% male), GFR was 93 mL/min (IQR 78–113), and surgery time was 259 min (IQR 217–307). Intraoperatively, 13.6 mL/min (7–31) was infused. In total, n=18 (21%) PF occurred. When the infusion : GFR ratio exceeded 0.15, PF increased from 11% to 34% (p=0.0157). No significant association was detected for any of the other parameters. Conclusions. This analysis demonstrates for the first time an association between intraoperative fluid excess and PF after PD with PJ even in patients with normal renal function. A carefully patient-adopted fluid management with due regard to renal function may help to prevent postoperative PF.

Assessment of renal function by inulin clearance: comparison with creatinine clearance as determined by enzymatic methods.

1989 ◽  
Vol 35 (2) ◽  
pp. 312-314 ◽  
Author(s):  
F S Apple ◽  
P Benson ◽  
P A Abraham ◽  
T G Rosano ◽  
C E Halstenson
Keyword(s):  
Renal Function ◽  
Glomerular Filtration Rate ◽  
Creatinine Clearance ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
The Other ◽  
Inulin Clearance ◽  
Urinary Creatinine ◽  
Single Slide ◽  
Enzymatic Methods

Abstract We compared creatinine clearances determined by enzymatic (Kodak Ektachem 700 single-slide, Boehringer Mannheim creatinine PAP) and nonenzymatic (Jaffé, HPLC) methods with glomerular filtration rate measured by inulin clearance in patients with varying degrees of renal function. The Kodak enzymatic assay gave values for creatinine 2 to 3 mg/L higher than the other methods. This resulted in significantly lower creatinine clearances than inulin clearances and creatinine clearances determined by the other methods. However, correlations between all methods for serum and urinary creatinine values and clearances were good. To avoid between assay (enzymatic vs nonenzymatic) discrepancies, manufacturers should agree to an acceptable standard of calibration under the usual conditions used with patients.

scholarly journals MO415DOES LOW CONTRAST VOLUMES REDUCE RATES OF CONTRAST-INDUCED NEPHROPATHY IN PATIENTS UNDERGOING CORONARY ANGIOGRAPHY?

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Emna Chaabouni ◽  
Hela Jbali ◽  
Najjar Mariem ◽  
Mzoughi Khadija ◽  
Zouaghi Mohamed karim
Keyword(s):  
Renal Function ◽  
Risk Factor ◽  
Glomerular Filtration Rate ◽  
Coronary Angiography ◽  
Contrast Media ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
Estimated Glomerular Filtration Rate ◽  
Contrast Induced Nephropathy ◽  
Contrast Dose

Abstract Background and Aims Coronary angiography (CAG) necessitates administration of iodinated contrast, which may precipitate an acute deterioration in renal function (contrast-induced nephropathy). Previous work on contrast-induced nephropathy (CIN) has identified contrast volume as a risk factor and suggested that there is a toxic contrast dose above which the risk of CIN is markedly increased. The focus of this study is to provide a critical appraisal of this modifiable risk factor. Method We prospectively enrolled 158 patients who CAG with or without percutaneous coronary intervention from December 2017 to February 2018 at a cardiology department . CIN was defined as an increase in serum creatinine level >25% or 0.5 mg/dL after 48 hours postcardiac catheterization. Toxic contrast dose was defined as a ratio volume of contrast media to estimated glomerular filtration rate (V/eGFR) > 2 . Multivariable regression was conducted to evaluate the effect of exceeding the toxic contrast dose on CIN. Results Of 158 patients (females = 36.1%, mean age 60.0 ± 11 years) who underwent CAG , 15 (9,5%) developed CIN . The volume administered of contrast was not related to the existence of postprocedure CIN (96,6±35,9 ml vs 102,5±33,7ml , p=0,16). However , it was associated with a higher incidence of CIN in patients with chronic renal failure (90±19,1 ml vs 116,6±73,7ml , p=0,008) . The mean V/eGFR value was 1,2±0,7.Nine percent of patients exceeded the toxic contrast dose. After adjusting for other known predictors of CIN, a V/eGFR ratio > 2 remained significantly associated with CIN (odds ratio 4.7, 95% confidence interval 1.28-17.7, P=0,02). Conclusion Low incidences of CIN suggest that a reduced dose of contrast agent is safe in high-risk patients with impaired renal function. A ratio volume of contrast media to estimated glomerular filtration rate > 2 is a significant and independent predictor of CIN after CAG.

scholarly journals Conversion to Everolimus was Beneficial and Safe for Fast and Slow Tacrolimus Metabolizers after Renal Transplantation

2020 ◽  
Vol 9 (2) ◽  
pp. 328 ◽  
Author(s):  
Gerold Thölking ◽  
Nils Hendrik Gillhaus ◽  
Katharina Schütte-Nütgen ◽  
Hermann Pavenstädt ◽  
Raphael Koch ◽  
...  
Keyword(s):  
Renal Function ◽  
Risk Factor ◽  
Renal Transplantation ◽  
Filtration Rate ◽  
Calcineurin Inhibitor ◽  
Estimated Glomerular Filtration Rate ◽  
Graft Function ◽  
Observation Time ◽  
Slow Metabolizers

Fast tacrolimus (TAC) metabolism (concentration/dose (C/D) ratio <1.05 ng/mL/mg) is a risk factor for inferior outcomes after renal transplantation (RTx) as it fosters, e.g., TAC-related nephrotoxicity. TAC minimization or conversion to calcineurin-inhibitor free immunosuppression are strategies to improve graft function. Hence, we hypothesized that especially patients with a low C/D ratio profit from a switch to everolimus (EVR). We analyzed data of 34 RTx recipients (17 patients with a C/D ratio <1.05 ng/mL/mg vs. 17 patients with a C/D ratio ≥1.05 ng/mL/mg) who were converted to EVR within 24 months after RTx. The initial immunosuppression consisted of TAC, mycophenolate, prednisolone, and basiliximab induction. During an observation time of 36 months after changing immunosuppression from TAC to EVR, renal function, laboratory values, and adverse effects were compared between the groups. Fast TAC metabolizers were switched to EVR 4.6 (1.5–21.9) months and slow metabolizers 3.3 (1.8–23.0) months after RTx (p = 0.838). Estimated glomerular filtration rate (eGFR) did not differ between the groups at the time of conversion (baseline). Thereafter, the eGFR in all patients increased noticeably (fast metabolizers eGFR 36 months: + 11.0 ± 11.7 (p = 0.005); and slow metabolizers eGFR 36 months: + 9.4 ± 15.9 mL/min/1.73 m2 (p = 0.049)) vs. baseline. Adverse events were not different between the groups. After the switch, eGFR values of all patients increased statistically noticeably with a tendency towards a higher increase in fast TAC metabolizers. Since conversion to EVR was safe in a three-year follow-up for slow and fast TAC metabolizers, this could be an option to protect fast metabolizers from TAC-related issues.

Clinical Renal Function Testing by External Double Isotope Monitoring Technique

1971 ◽  
Vol 10 (01) ◽  
pp. 16-24
Author(s):  
J. Fog Pedersen ◽  
M. Fog Pedersen ◽  
Paul Madsen
Keyword(s):  
Renal Function ◽  
Glomerular Filtration Rate ◽  
Glomerular Filtration ◽  
Plasma Flow ◽  
Filtration Rate ◽  
Renal Plasma Flow ◽  
Correlation Coefficients ◽  
Feedback System ◽  
Effective Renal Plasma Flow ◽  
Advantages And Disadvantages

SummaryAn accurate catheter-free technique for clinical determination simultaneouslyof glomerular filtration rate and effective renal plasma flow by means of radioisotopes has been developed. The renal function is estimated by the amount of radioisotopes necessary to maintain a constant concentration in the patient’s blood. The infusion pumps are steered by a feedback system, the pumps being automatically turned on when the radiation measured over the patient’s head falls below a certain preset level and turned off when this level is again readied. 131I-iodopyracet was used for the estimation of effective renal plasma flow and125I-iothalamate estimation of the glomerular filtration rate. These clearances were compared to the conventional bladder clearances and good correlation was found between these two clearance methods (correlation coefficients 0.97 and.90 respectively). The advantages and disadvantages of this new clearance technique are discussed.

Darwin's two competing phylogenetic trees: marsupials as ancestors or sister taxa?

2012 ◽  
Vol 39 (2) ◽  
pp. 217-233 ◽  
Author(s):  
J. David Archibald
Keyword(s):  
Fossil Record ◽  
Evolutionary Biology ◽  
Phylogenetic Trees ◽  
Charles Darwin ◽  
The Other ◽  
Charles Lyell ◽  
Single Origin ◽  
Molecular Studies ◽  
Richard Owen ◽  
First Time

Studies of the origin and diversification of major groups of plants and animals are contentious topics in current evolutionary biology. This includes the study of the timing and relationships of the two major clades of extant mammals – marsupials and placentals. Molecular studies concerned with marsupial and placental origin and diversification can be at odds with the fossil record. Such studies are, however, not a recent phenomenon. Over 150 years ago Charles Darwin weighed two alternative views on the origin of marsupials and placentals. Less than a year after the publication of On the origin of species, Darwin outlined these in a letter to Charles Lyell dated 23 September 1860. The letter concluded with two competing phylogenetic diagrams. One showed marsupials as ancestral to both living marsupials and placentals, whereas the other showed a non-marsupial, non-placental as being ancestral to both living marsupials and placentals. These two diagrams are published here for the first time. These are the only such competing phylogenetic diagrams that Darwin is known to have produced. In addition to examining the question of mammalian origins in this letter and in other manuscript notes discussed here, Darwin confronted the broader issue as to whether major groups of animals had a single origin (monophyly) or were the result of “continuous creation” as advocated for some groups by Richard Owen. Charles Lyell had held similar views to those of Owen, but it is clear from correspondence with Darwin that he was beginning to accept the idea of monophyly of major groups.

RENAL FUNCTION AND KIDNEY SIZE FOLLOWING HYPOPHYSECTOMY IN MAN

1965 ◽  
Vol 48 (3) ◽  
pp. 348-354 ◽  
Author(s):  
Thomas Falkheden ◽  
Ingmar Wickbom
Keyword(s):  
Renal Function ◽  
Diabetic Retinopathy ◽  
Glomerular Filtration Rate ◽  
Plasma Flow ◽  
Mammary Carcinoma ◽  
Filtration Rate ◽  
Renal Plasma Flow ◽  
Kidney Weight ◽  
Kidney Size ◽  
Before And After

ABSTRACT Measurements of glomerular filtration rate (GFR) and renal plasma flow (RPF) were performed in close connection with roentgenographic estimation of kidney size, before and after hypophysectomy, in 10 patients (four cases of metastatic mammary carcinoma, five cases of diabetic retinopathy and one case of acromegaly). Hypophysectomy was regularly followed by a decrease in GFR and RPF. In most cases, a reduction in the roentgenographic kidney size was also observed. However, the changes in the roentgenographic kidney size and calculated kidney weight after hypophysectomy were smaller and occurred at a slower rate than the alterations in GFR and RPF. The results favour the view that, primarily, the decrease in GFR and RPF following hypophysectomy is essentially functional rather than due to a reduced kidney mass.

Early Renal Dysfunction in Obese Patients with Insulin Resistance

2019 ◽  
Vol 26 (3) ◽  
pp. 261-265
Author(s):  
Natalia Pertseva ◽  
Mariia Rokutova
Keyword(s):  
Insulin Resistance ◽  
Renal Function ◽  
Renal Dysfunction ◽  
Filtration Rate ◽  
Diagnostic Value ◽  
Glomerular Hyperfiltration ◽  
Model Assessment ◽  
Homa Index ◽  
Obese Patients ◽  
Homeostasis Model Assessment

Abstract Background and aims. Obese individuals have insulin resistance status assessed in the present study by the HOMA index (“Homeostasis model assessment”). This prospective study assessed renal disorders in the insulin resistance in obese patients. Material and Methods. The study included 73 young obese patients. The assessment included the HOMA index before meal and parameters of renal function (glomerular filtration rate, albuminuria, β2-microglobulinuria). Results. In young obese, insulin-resistance patients, glomerular hyperfiltration and β2-microglobulinuria are found in 77.0 and 93.4% of cases respectively. The albuminuria is noted in some cases, which reduces diagnostic value. Conclusions. In young obese patients with insulin resistance, glomerular hyperfiltration and β2-microglobulinuria are main diagnostic markers of renal dysfunction.

SCANNING ELECTRON MICROSCOPE: POSSIBILITIES FOR STUDYING KIDNEY DISEASES

2020 ◽  
pp. 176-182
Author(s):  
Mamaeva S.N. ◽  
Vinokurov R.R. ◽  
Munkhalova Ya.A. ◽  
Dyakonova D.P. ◽  
Platonova V.A. ◽  
...  
Keyword(s):  
Electron Microscopy ◽  
Scanning Electron Microscopy ◽  
Electron Microscope ◽  
Scanning Electron Microscope ◽  
Red Blood Cells ◽  
Blood Cells ◽  
Filtration Rate ◽  
Kidney Diseases ◽  
First Time ◽  
Scanning Electron

Currently, due to the intensive development of high-tech science-intensive medical and research devices, more and more attention is paid to the development of diagnostics of rare and difficult to diagnose diseases. It is known that among numerous nephropathies, hematuria may be the only symptom of kidney and urinary tract diseases, which complicates their diagnosis and treatment. In order to develop new approaches for the diagnosis of nephropathies, the authors have been studying the morphology of red blood cells in the blood and urine of children and adults using a scanning electron microscope for several years. The paper presents the results of studies of children with various kidney diseases, including IgA-nephropathy, and chronic glomerulonephritis. Scanning electron microscopy was used for the first time to detect nanoparticles on the surface of red blood cells, the size of which is comparable to the size of viruses, which became the basis for one of the authors ' assumptions, namely, the possible transport of certain types of viruses by red blood cells. Thus, some kidney diseases could be considered virus-associated. This paper presents for the first time the results of determining the glomerular filtration rate of both kidneys separately in the study of separate kidney function and of the study of urine smears obtained during catheterization of the ureters in patients with hydronephrosis of one of the kidneys by scanning electron microscopy. As in previous studies, nanoparticles were found on the surface of red blood cells, which leads to the conclusion about the possible viral nature of the disease of the considered patient. In addition, smear images obtained using a microscope showed a significant difference in the elements of the right and left kidneys urine, which did not contradict the data on the study of glomerular filtration rate. According to the authors, the capabilities of the scanning electron microscope can be applied in fundamental research of kidney diseases at the cellular and molecular levels, forming new ideas about their origin, as well as on the basis of which new methods of non-invasive diagnostics can be built.

Sphagnum mosses (Sphagnaceae, Bryophyta) of mires Chefandzar and Masota in North Ossetia (Caucasus)

2018 ◽  
Vol 52 (2) ◽  
pp. 455-462 ◽  
Author(s):  
G. Ya. Doroshina ◽  
I. A. Nikolajev
Keyword(s):  
Plant Communities ◽  
The Other ◽  
North Caucasus ◽  
Sphagnum Mosses ◽  
Greater Caucasus ◽  
The North ◽  
First Time ◽  
North Ossetia

Sphagnum mires on the Greater Caucasus are rare, characterized by the presence of relict plant communities of glacial age and are in a stage of degradation. The study of Sphagnum of Chefandzar and Masota mires is carried out for the first time. Seven species of Sphagnum are recorded. Their distribution and frequency within the North Caucasus are analyzed. Sphagnum contortum, S. platyphyllum, S. russowii, S. squarrosum are recorded for the first time for the study area and for the flora of North Ossetia. The other mosses found in the study area are listed.

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