Late Evaluation of Glomerular Filtration Rate, Proteinuria, and Urinary Acidification After Acute Tubular Necrosis

Renal Failure ◽  
1992 ◽  
Vol 14 (1) ◽  
pp. 57-61 ◽  
Author(s):  
Regina Abdulkader ◽  
Patricio Malheiro ◽  
Elizabeth Daher ◽  
Helga Cruz ◽  
Luiz Yu ◽  
...  
1975 ◽  
Vol 53 (4) ◽  
pp. 660-668 ◽  
Author(s):  
Mortimer Levy

Glucagon in small intravenous (i.v.) doses markedly increases glomerular filtration rate (GFR) in normal anesthetized dogs. In this study, the effects of glucagon 5 μg/min (i.v.) on renal hemodynamics was tested in four canine models of acute pre-renal failure (hemorrhage, barbiturate overdose; renal arterial clamping and renal arterial infusions of noradrenaline) and in a model of unilateral acute tubular necrosis at 4 h and 6–7 days following completion of the ischemic insult. Following hemorrhage and barbiturate excess, with arterial blood pressure maintained at 65–70 mm Hg, whole-kidney GFR and clearance rate of p-aminohippurate decreased by 50–70%. During this reduction of perfusion pressure, the subsequent infusion of glucagon increased GFR by 90–130%. In models where arterial pressure was normal during the period of ischemia (clamping and noradrenaline infusion), not only did glucagon significantly increase renal perfusion, but the ischemic kidney proved to be far more sensitive to the hemodynamic effects of glucagon (ΔGFR = 120–160%) than the contralateral control (ΔGFR = 30–40%). In three dogs completely anuric following renal arterial clamping, glucagon was able to improve blood flow and restart urine formation. Glucagon, but not dopamine, was able to simulate the beneficial effects of hypertonic mannitol on renal function in dogs with hemorrhagic hypotension. Glucagon was without effect in established acute tubular necrosis. This study, therefore, indicates that, during renal ischemia, glucagon may be quite effective in preserving urine output and perfusion of the kidneys.


1973 ◽  
Vol 45 (1) ◽  
pp. 1-17 ◽  
Author(s):  
R. R. Bailey ◽  
R. Natale ◽  
D. I. Turnbull ◽  
A. L. Linton

1. Acute tubular necrosis (ATN) with acute renal failure (ARF) was induced in rats with (a) a combination of subcutaneous (s.c.) cephaloridine 500 mg/kg, frusemide 50 mg/kg and 4 ml/kg of 50% (v/v) glycerol in sterile water, (b) s.c. cephaloridine 1500 mg/kg, (c) s.c. mercuric chloride 2·0 and 4·7 mg/kg and (d) both s.c. and intramuscular glycerol (10 ml/kg in sterile water). 2. Pretreatment of rats with varying doses of frusemide protected against both the ATN and ARF of all the models except for glycerol where the ATN and ARF was aggravated. The protection against the ATN of cephaloridine alone and the ATN and ARF of the cephaloridine-glycerol-frusemide combination was almost complete if the last (or only) frusemide pretreatment injection was given 5–12 h before the challenge. Frusemide administered together with cephaloridine makes the ATN and ARF more severe. 3. The pretreatment regime results in moderate dehydration, a lowered serum potassium, a markedly elevated plasma renin activity and a reduced glomerular filtration rate. All these factors would be expected to increase the damage resulting from the nephrotoxic challenges, rather than to protect against it. 4. The possible mechanism of this protection conferred by frusemide pretreatment on the ‘toxic’ type of ARF is discussed. With this type of nephrotoxic insult the resulting ATN involves mainly the proximal convoluted tubules. The potentiation of the ‘circulatory’ type of ARF by frusemide pretreatment probably results from the effects of dehydration.


1971 ◽  
Vol 10 (01) ◽  
pp. 16-24
Author(s):  
J. Fog Pedersen ◽  
M. Fog Pedersen ◽  
Paul Madsen

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.


2020 ◽  
pp. 44-48
Author(s):  
V. A. Aleksandrov ◽  
L. N. Shilova ◽  
A. V. Aleksandrov

The development of renal dysfunction in patients with rheumatoid arthritis (RA) is due to the presence and severity of autoimmune disorders, chronic systemic inflammation, a multiplicity of comorbid conditions, and pharmacotherapy features. The most important parameter that describes the general condition of the kidneys is glomerular filtration rate (GFR). This review presents the data on the possibilities of modern methods for determining estimated GFR (e-GFR) and the specificity of their use in various clinical situations that accompany the course of RA. For the initial assessment of GFR in patients with RA it is advisable to use the measurement of e-GFR based on serum creatinine concentration using the CKD-EPI equation (2009) (with or without indexing by body surface area). In cases where the e-GFR equations are not reliable enough or the results of this test are insufficient for clinical decision making, the serum cystatin C level should be measured and the combined GFR calculation based on creatinine and cystatin C should be used.


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