Is it possible to predict renal function in small animals using a multi-pinhole SPECT system?
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Animals↗
Biomedical subjects
Alain Prigent
Publications and source records attributed to Alain Prigent.
At what level of unilateral renal impairment does contralateral functional compensation occur?
Functional compensation occurs in a kidney when the function of the contralateral kidney is decreased or absent. What is, however, not documented is the level of unilateral renal impairment at which functional compensation occurs. Split function, as obtained from a radionuclide renogram, can only show the asymmetry between both kidneys. The aim of the present work was to evaluate at what level of unilateral impairment a functional compensation can be observed in the contralateral normal kidney. From a large database, 180 children over 2 years of age with unilateral pathology were retrospectively selected. All of them underwent a radionuclide study, combining a technetium-99m mercaptoacetyltriglycine (Tc-99m MAG3) renogram associated with a chromium-51 ethylenediaminetetraacetic acid (Cr-51 EDTA) overall clearance, allowing a precise estimation of single-kidney glomerular filtration rate (SKGFR). Below 30-35 ml/min/1.73 m2, there was a significant inverse correlation between SKGFR on the normal and the abnormal side. Above this level, no such correlation was observed, the mean SKGFR on the normal side remaining around 58 ml/min/1.73 m2, whatever the value of SKGFR on the abnormal side. In pediatric patients, hyperfunction occurs when SKGFR of the diseased kidney is below 30-35 ml/min/1.73 m2.
Adaptation, Physiological↗
Changes in renal function in patients with familial amyloid polyneuropathy treated with orthotopic liver transplantation.
BACKGROUND: Familial amyloid polyneuropathy (FAP) is an autosomal dominant disease caused by a point mutation in the gene encoding transthyretin, which is secreted by the liver. Orthotopic liver transplantation (OLT) has been proposed to prevent disease progression. Little is known about long-term changes in renal function and lesions after OLT. METHODS: The renal function of 33 patients with FAP was evaluated (proteinuria, serum creatinine, creatinine clearance) before OLT and over a period of at least 5 years afterwards. A pre-transplantation renal biopsy was performed in 14 patients and a follow-up biopsy in eight patients. RESULTS: Before transplantation, mean serum creatinine concentration was 86 micromol/l (47-126 micromol/l) and creatinine clearance was 71.9+/-31.6 ml/min/1.73 m(2). Proteinuria was detected in 54% of patients (0.3-4 g/day). Pre-transplant renal biopsies (n = 14) revealed glomerular, tubular and vascular amyloid deposits in 90, 58 and 66% of patients, respectively. Eleven patients (33%) died after OLT. Death occurred most frequently in patients having weight losses >7 kg (P<0.05). After transplantation, 25 patients (76%) suffered acute renal failure but only one required dialysis. One month after transplantation, the mean serum creatinine concentration was 134.1+/-73 micromol/l and remained constant during follow-up. Eight patients underwent a second renal biopsy 2 years after transplantation. No significant changes in deposits or renal toxicity due to calcineurin inhibitors were detected. CONCLUSION: Although liver transplantation in FAP does not affect existing renal amyloid deposits, it prevents the progression of renal disease.
Adult↗