EFFECT OF ADRENOCORTICOTROPIC HORMONE (ACTH) AND CORTISONE ON PROTEINURIA AND HEMATURIA IN THE NEPHROTIC SYNDROME

PEDIATRICS ◽  
1955 ◽  
Vol 15 (1) ◽  
pp. 49-53
Author(s):  
Walter Heymann ◽  
Caroline Gilkey ◽  
Milena Salehar
Keyword(s):  
Nephrotic Syndrome ◽  
Plasma Protein ◽  
Protein Concentration ◽  
Adrenocorticotropic Hormone ◽  
Hormone Treatment ◽  
Oncotic Pressure ◽  
Plasma Protein Concentration

1. Fifteen children suffering from the nephrotic syndrome were treated with 22 courses of either ACTH or cortisone. Three children failed to have a diuresis during 4 courses of treatment. No decrease in proteinuria was noted. Eighteen courses of hormone treatment resulted in diuresis in 12 patients. A decrease in proteinuria preceded diuresis in each instance. [See Table II, Fig. 2 and Fig. 3 in Source Pdf] 2. A relationship between severity of hypoproteinemia and onset of diuresis, once proteinuria has started to decrease, has been established. 3. It is concluded that one of the important actions of ACTH or cortisone in inducing diuresis is concerned with the decrease in proteinuria, resulting in increasing plasma protein concentration and oncotic pressure. 4. The effect of these hormones on hematuria in nephrosis has been noted during 4 courses of treatment. In these proteinuria decreased appreciably. In 4 instances hematuria persisted and proteinuria decreased only slightly or not at all.

scholarly journals Colloid Oncotic Pressure in Children with Nephrotic Syndrome

2019 ◽  
Vol 28 (9-10) ◽  
pp. 200-8
Author(s):  
Taralan Tambunan ◽  
H. Alatas ◽  
I. G. N. Wila Wirya ◽  
S. Harmanses ◽  
I. Chair ◽  
...  
Keyword(s):  
Nephrotic Syndrome ◽  
Plasma Protein ◽  
Protein Concentration ◽  
Low Grade ◽  
Oncotic Pressure ◽  
Plasma Albumin ◽  
Plasma Protein Concentration ◽  
Strong Negative Correlation ◽  
Total Plasma Protein ◽  
Albumin Content

To evaluate the correlation between plasma protein concentration and colloid oncotic pressure (COP) and their influence on clinical symptom of edema, we studied 30 children with nephrotic syndrome (NS). Total plasma protein concentration (TP), albumm, globulin and COP were measured in all patients in edema forming state (EF) and m steady state phase (SS), except for COP, only 16 samples in SS phase. COP TP plasma albumin and globulin contents in EF group were 8. 7 ± 2. 7 mmHg, 4.07 '± 0.68 g/dl; 2.57 ± 0.50 g/dl and 1.51 ± 0.32 g/dl, respectively. In SS group these figures rose significantly to 16.7 ± 3.9 mmHg for COP; 5. 70 ± 0.99 g/dl for TP; 3.46 ± 0.52 g!dl and 2.06 ± 0.56 g/dl for plasma albumin and globulin, respectively. We also found the high correlation both between COP and albumin content (r= +0.58; p < 0.01) and between COP and TP (r= +0.54; P < 0.01) . A strong negative correlation was also found between COP and the degree of edema (r = _ 0.55; p <0.01). On the other hand a very low grade correlation was noticed between plasma albumin content and  the degree of edema (r= - 0.26; P < 0.05) and no correlation at all was found between edema and TP (r= - 0.19; P > 0.05). We conclude that COP has the highest correlation with plasma protein concentration and the degree of edema, and can be used as a diagnostic tool. It is even more sensitive and simple compared with the TP or albumin content determination.

Effects of hypoproteinemia and increased vascular pressure on lung fluid balance in sheep

1983 ◽  
Vol 55 (5) ◽  
pp. 1514-1522 ◽  
Author(s):  
G. C. Kramer ◽  
B. A. Harms ◽  
B. I. Bodai ◽  
E. M. Renkin ◽  
R. H. Demling
Keyword(s):  
Plasma Protein ◽  
Fluid Balance ◽  
Protein Concentration ◽  
Lymph Flow ◽  
Base Line ◽  
Oncotic Pressure ◽  
Plasma Protein Concentration ◽  
Lung Fluid ◽  
Lung Fluid Balance ◽  
Normal Plasma

We compared the effects of a sustained decrease in plasma oncotic pressure on lung fluid balance with those of an increase in vascular pressure in six unanesthetized sheep. Initial plasma protein concentration of 58.0 +/- 2.2 (SE) mg/ml was quickly reduced to 34.0 +/- 1.4 mg/ml via plasmapheresis and held at this value for 24 h. Red cells were returned with lactated Ringer solution infused at a rate adjusted to maintain central venous pressure; cardiac output and pulmonary vascular pressures also remained at base line. Steady-state lymph flows increased from a base-line value of 8.8 +/- 3.2 to 20.1 +/- 5.6 ml/h, while the lymph-to-plasma protein concentration ratio ( [L/P] ) decreased from 0.65 +/- 0.03 to 0.44 +/- 0.04. Decreased lymph protein resulted in reestablishment of base-line plasma-to-lymph oncotic gradient. The increased lymph flow was not the result of increased filtration forces, since all vascular pressures and the oncotic gradient were unchanged; nor was it due entirely to increased surface area since [L/P] was decreased. The decrease in plasma oncotic pressure, delta pi P, was twice as effective at increasing lymph flow (1.66 ml X h-1 X mmHg-1, delta pi P) as an equivalent increase in microvascular pressure, delta PC, at normal plasma protein concentration (0.82 ml X h-1 X mmHg-1, delta PC). Elevation of microvascular pressure during hypoproteinemia had a greater effect on lymph flow (1.44 ml X h-1 X mmHg-1, delta PC) than at normal plasma protein concentration.(ABSTRACT TRUNCATED AT 250 WORDS)

Permeability characteristics of colonic capillaries

1980 ◽  
Vol 239 (4) ◽  
pp. G300-G305 ◽  
Author(s):  
P. D. Richardson ◽  
D. N. Granger ◽  
D. Mailman ◽  
P. R. Kvietys
Keyword(s):  
Pressure Gradient ◽  
Plasma Protein ◽  
Protein Concentration ◽  
Venous Pressure ◽  
Molecular Size ◽  
Lymph Flow ◽  
Oncotic Pressure ◽  
Plasma Protein Concentration ◽  
Permeability Characteristics ◽  
Pressure Elevation

Blood flow, lymph flow, lymph protein concentration (CL), lymph oncotic pressure, plasma protein concentration (CP), and plasma oncotic pressure were determined under steady-state conditions at venous pressures of 0, 10, 20, 30, and 40 mmHg in autoperfused segments of dog colon. Venous pressure elevation increased colonic vascular resistance, lymph flow, lymphatic protein flux, and the transcapillary oncotic pressure gradient, whereas the lymph-to-plasma protein concentration ratio (CL/CP) declined. The osmotic reflection coefficient (sigma d) was estimated using sigma d = 1-CL/CP when CL/CP is filtration independent (high lymph flows). For total protein sigma d = 0.85 +/- 0.02. Values of sigma d for plasma protein fractions with molecular radii ranging between 37 and 120 A increased as molecular radius increased. The results of this study suggest that 1) colonic capillaries selectively restrict macromolecules on the basis of molecular size, and 2) an increased lymph flow and transcapillary oncotic pressure gradient may play an important role in preventing interstitial edema subsequent to venous pressure elevation in the dog colon.

scholarly journals Regulation of maternal ACTH in ovine pregnancy: does progesterone play a role?

2008 ◽  
Vol 295 (4) ◽  
pp. E913-E920 ◽  
Author(s):  
Maureen Keller-Wood ◽  
Charles E. Wood
Keyword(s):  
Plasma Protein ◽  
Plasma Volume ◽  
Plasma Proteins ◽  
Plasma Cortisol ◽  
Protein Concentration ◽  
Adrenocorticotropic Hormone ◽  
Mineralocorticoid Receptors ◽  
Plasma Acth ◽  
Plasma Protein Concentration

Pregnancy is characterized by increased plasma adrenocorticotropic hormone (ACTH) and cortisol. Studies suggest that progesterone acts as an antagonist at mineralocorticoid receptors. Therefore, we tested the hypothesis that chronic progesterone, produced by treatment of nonpregnant ewes or during pregnancy, will result in increased plasma ACTH relative to the plasma cortisol concentrations. We studied three groups of ewes: ovariectomized nonpregnant, nonpregnant treated with progesterone, and pregnant ewes. In two series of studies, ewes were adrenalectomized and replaced with 0.35 mg·kg−1·day−1 or 0.5 mg·kg−1·day−1 cortisol. In both studies, aldosterone was infused at 3 μg·kg−1·day−1. In the first study, additional infusions of cortisol over 24 h were used to increase daily replacement doses to 0.5, 1, or 1.5 mg·kg−1·day−1, and intact pregnant and nonpregnant ewes were studied with infusions of cortisol at 0, 0.5, and 1 mg·kg−1·day−1. In adrenalectomized ewes chronically replaced to 0.35 mg·kg−1·day−1 cortisol, plasma ACTH concentrations were decreased significantly in the nonpregnant progesterone-treated ewes compared with the ovariectomized nonpregnant ewes. With 0.5 mg·kg−1·day−1 cortisol, plasma ACTH levels were greater in pregnant ewes than in nonpregnant ewes with or without progesterone. Overall plasma ACTH levels at 0.35 mg·kg−1·day−1 were significantly related to the plasma protein concentration, suggesting that the ACTH levels in the hypocorticoid ewes are most closely related to plasma volume. Across all steroid doses, ACTH was positively related to plasma proteins and progesterone, and negatively related to cortisol. We conclude that increased progesterone does not alter the feedback relation of cortisol to ACTH, but may modulate ACTH indirectly through plasma volume.

Dynamics of glomerular ultrafiltration. IX. Effects of plasma protein concentration

1977 ◽  
Vol 232 (1) ◽  
pp. F58-F71 ◽  
Author(s):  
C. Baylis ◽  
I. Ichikawa ◽  
W. T. Willis ◽  
C. B. Wilson ◽  
B. M. Brenner
Keyword(s):  
Plasma Protein ◽  
Protein Concentration ◽  
Oncotic Pressure ◽  
Experimental Conditions ◽  
Plasma Protein Concentration ◽  
Mean Values ◽  
Concomitant Reduction ◽  
Single Nephron ◽  
Glomerular Ultrafiltration ◽  
Predicted Values

Experiments were carried out on 42 Munich-Wistar rats with surface glomeruli accessible to micropuncture to investigate the effects of reduction in systemic plasma protein concentration. CA, and thus afferent oncotic pressure, IIA, on the determinants of glomerular ultrafiltration. In animals in which CA was reduced by a variety of maneuvers, observed values for single-nephron GFR were lower than values predicted by the Starling relation, when the latter were calculated assuming that the observed increase in the net driving pressure for ultrafiltration (due to the reduction in IIA) was the only factor perturbed. In all experimental conditions where CA was reduced, rats were invariably observed to be at filtration pressure disequilibrium, permitting calculation of unique values of the ultrafiltration coefficient, Kt. In all low-CA groups, mean values of Kf were uniformly lower than values obtainedin normoproteinemic control animals. The failure of SNGFR to rise to predicted values when CA is reduced is therefore due to the concomitant reduction in Kf. No morphological basis for this reduction in Kf was discerned.

Effects of hypoproteinemia-induced myocardial edema on left ventricular function

1998 ◽  
Vol 274 (3) ◽  
pp. H937-H944 ◽  
Author(s):  
M. Miyamoto ◽  
D. E. McClure ◽  
E. R. Schertel ◽  
P. J. Andrews ◽  
G. A. Jones ◽  
...  
Keyword(s):  
Plasma Protein ◽  
Protein Concentration ◽  
Systolic Dysfunction ◽  
Myocardial Edema ◽  
Left Ventricular ◽  
Control Group ◽  
Lv Function ◽  
Stroke Work ◽  
Plasma Protein Concentration ◽  
Total Plasma Protein

In previous studies, we observed left ventricular (LV) systolic and diastolic dysfunction in association with interstitial myocardial edema (IME) induced by either coronary venous hypertension (CVH) or lymphatic obstruction. In the present study, we examined the effects of myocardial edema induced by acute hypoproteinemia (HP) on LV systolic and diastolic function. We also combined the methods of HP and CVH (HP-CVH) to determine their combined effects on LV function and myocardial water content (MWC). We used a cell-saving device to lower plasma protein concentration in HP and HP-CVH groups. CVH was induced by inflating the balloon in the coronary sinus. Six control dogs were treated to sham HP. Conductance and micromanometer catheters were used to assess LV function. Contractility, as measured by preload recruitable stroke work, did not change in control or HP groups but declined significantly (14.5%) in the HP-CVH group. The time constant of isovolumic LV pressure decline (τ) increased significantly from baseline by 3 h in the HP (24.8%) and HP-CVH (27.1%) groups. The end-diastolic pressure-volume relationship (stiffness) also increased significantly from baseline by 3 h in the HP (78.6%) and HP-CVH (42.6%) groups. Total plasma protein concentration decreased from 5.2 ± 0.2 g/dl at baseline to 2.5 ± 0.0 g/dl by 3 h in the HP and HP-CVH groups. MWC of the HP (79.8 ± 0.25%) and HP-CVH groups (79.8 ±0.2%) were significantly greater than that of the control group (77.8 ± 0.3%) but not different from one another. In conclusion, hypoproteinemia-induced myocardial edema was associated with diastolic LV dysfunction but not systolic dysfunction. The edema caused by hypoproteinemia was more than twice that produced by our previous models, yet it was not associated with systolic dysfunction. CVH had a negative inotropic effect and no significant influence on MWC. IME may not have the inverse causal relationship with LV contractility that has been previously postulated but appears to have a direct causal association with diastolic stiffness as has been previously demonstrated.

scholarly journals PLASMA PROTEIN CONCENTRATION AND RECOVERY FROM ANAESTHESIA IN MAN

1981 ◽  
Vol 53 (12) ◽  
pp. 1281-1284 ◽  
Author(s):  
G. TORRI ◽  
L. STELLA ◽  
G. PRADELLA ◽  
E. MAESTRONE ◽  
C. MARTANI
Keyword(s):  
Plasma Protein ◽  
Protein Concentration ◽  
Plasma Protein Concentration
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