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Biomedical subjects

H K Petersen

Publications and source records attributed to H K Petersen.

5 recordsLinked to original sources
PubMed1985

Effect of hypothermic renal ischaemia on renin secretion rate in man.

Plasma renin concentration (PRC), renal blood flow (RBF) and renin secretion rate (RSR = renal veno-arterial PRC difference multiplied by renal plasma flow) were measured before and after a period of hypothermic renal ischaemia in seven patients undergoing surgery for renal calculi. After hypothermic (10-15 degrees C) ischaemia (duration 36 to 71 min) the temperature rose to 37 degrees C within 4 min, while RSR decreased transiently in the posthypothermic postocclusive period. Maximal decrease in RSR (-65%) was found 6 min after re-establishment of the renal perfusion, and 30 min later RSR was similar to the prehypothermic, preocclusive value. RBF decreased in the same period, while mean arterial blood pressure and renal oxygen uptake were unchanged. The results are compatible with a reversible depression of the release of renin in the postocclusive, posthypothermic human kidney.

Adult↗
PubMed1977

Regional hypothermia in renal surgery for severe lithiasis.

An active approach to severe renal lithiasis is advocated, though operative procedures often require interruption of the blood supply. Te evaluate the effect of ischemia on the kidney the literature has been searched and we have reached the following conclusions. A warm ischemic time of more than 20 minutes causes a brief and transitory reduction in renal function. If ischemia exceeds 30-40 minutes many kidneys will not regain their previous function. If the kidney's temperature is lowered to about 15 degrees C, ischemia can be tolerated for up to 12 hours. A priori these time limits applicable to normal kidneys are to broad for use in diseased kidneys. Cooling of the kidney can be achieved by either perfusion-cooling or by external parenchymatous cooling. We describe a method using the latter system for stone removal in 14 patients with staghorn calculi or multiple stones. Preoperatively 9 patients (64%) had persistent urinary tract infection, whereas infection persisted in only 2 patients following the operation (14%). Complete stone removal was achieved in 13 patients (93%). Renal function evaluated by creatinine clearance and renography generally improved following operation. There were no deaths, but in 9 patients severe complications were seen (transient oliguria and septicemia). At follow-up investigation 1.5 years after operation renewed stone formation was found in 1 patient, while the incidence of urinary tract infection had increased to 3 patients (21%). It is concluded that extensive surgery for stone removal with the use of external parenchymatous cooling is worthwhile and promising in patients with staghorn calculi or multiple stones in the kidneys.

Adult↗
PubMed1976

Nephrectomy. A five-year material.

A review of 158 consecutive nephrectomies is presented. The pathological findings are listed and compared to other author's findings. In the present series a very low rate of nephrectomy necessitated by stone and infection is noted. Surprisingly, 14 normal kidneys were removed. The specific diagnostic problems in each case are discussed, and better diagnostic procedures in the future are mentioned.

Adolescent↗
PubMed1976

Experience with one-stage bilateral nephrectomy.

Eight patients with uremia were treated by one-stage transperitoneal bilateral nephrectomy prior to transplantation. Four of the patients had refractory hypertension with high peripheral renin activity which was unresponsive to drug treatment and vigorous hemodialysis. All obtained a normal blood pressure after operation. Two patients were nephrectomised to combat chronic infection, whilst one of the two remaining patients suffered from huge polycystic kidneys and the other had suspected Goodpasture syndrome. There were no deaths and the only complications observed were one instance of hyperkalemia necessitating acute hemodialysis and one instance of prolonged ileus. Our indications for doing the operation prior to transplantation have been very restricted, but when the operation becomes necessary, it is a safe procedure.

Adult↗