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Biomedical subjects

J E Springate

Publications and source records attributed to J E Springate.

At least 19 recordsLinked to original sources
PubMed1992

Serum creatinine level and renal function in children.

OBJECTIVE: To evaluate the accuracy of serum creatinine and height/serum creatinine glomerular filtration rate (Cr-GFR) formula as screening tests for abnormal renal function defined by plasma diethylenetriaminepenta-acetic acid (DTPA) clearance. DESIGN: Patient series. SETTING: The Children's Hospital of Buffalo (NY). PATIENTS: Eighty-seven consecutive patients ranging in age from 2 to 20 years. MEASUREMENTS: The Cr-GFR was calculated by means of the formula GFR (milliliters per minute per 1.73 m2) = kL/serum creatinine (milligrams per deciliter), where L is body length in centimeters and k is a constant dependent on age and sex. Plasma clearance of technetium Tc 99m-labeled DTPA was our reference method for determination of GFR (DTPA-GFR). RESULTS: The Cr-GFR formula identified children with impaired renal function (DTPA clearance, less than 80 mL/min per 1.73 m2) with a sensitivity of 95% and a specificity of 93%. In contrast, the sensitivity and specificity of elevated serum creatinine level for this purpose were 80% and 96%, respectively. Of the children with renal insufficiency (DTPA clearance, 40 to 79 mL/min per 1.73 m2), 91% were correctly identified by the Cr-GFR formula. However, only 65% of these children had elevated serum creatinine levels. Although all children with renal failure (DTPA clearance, less than 40 mL/min per 1.73 m2) had abnormally high serum creatinine levels, the specificity of this test was significantly lower than that of the Cr-GFR formula (75% vs 100%, respectively). CONCLUSIONS: The Cr-GFR formula is superior to serum creatinine level for estimating GFR. This formula provides a simple, reasonably accurate screening test for the presence and severity of impaired renal function.

Adolescent↗
PubMed1992

Glomerular function in spontaneously diabetic rats.

This study was undertaken to determine whether hyperfiltration exists at the single nephron level and whether albumin excretion is increased early in the course of diabetes in Biobreeding rats. Diabetic rats were studied at 8-12 weeks after the onset of diabetes. Control animals were age-matched, diabetes-resistant rats. Urinary and tubular fluid albumin concentrations were measured by polyacrylamide gel electrophoresis. Clearance and micropuncture techniques were used to determine whole kidney and single nephron glomerular filtration rate, renal blood flow, and glomerular capillary pressure. The urinary albumin excretion rate (1.3 +/- 0.1 mg/24 hr) and the tubular fluid albumin concentration (4.7 +/- 0.7 mg/dl) in the diabetic group were significantly elevated when compared with urinary albumin excretion (0.9 +/- 0.1 mg/24 hr) and tubular fluid albumin concentration (2.5 +/- 0.5 mg/dl) in the control group. There were no significant differences in glomerular hemodynamics (whole kidney or single nephron glomerular filtration rate or glomerular capillary pressure) between diabetic and control rats. The kidney weight and kidney weight to body weight ratio were significantly higher in diabetic rats when compared with control rats. Early diabetes in Biobreeding rats is characterized by mild albuminuria and increased kidney size, but not glomerular hyperfiltration.

Animals↗
PubMed1991

Progressive glomerular injury after recovery from acute glomerulonephritis in rats.

To determine if an acute immunologic injury resembling poststreptococcal nephritis could lead to chronic renal injury, rats with immune-complex glomerulonephritis produced with cationic human gammaglobulin were followed for 48 weeks. During Week 1, animals developed severe proteinuria, hypoalbuminemia, and a diffuse proliferative/exudative glomerulitis. Substantial recovery, characterized by a significant decline in urinary protein excretion and normalization of plasma albumin concentration, occurred by Week 4. Subsequently, rats developed significantly elevated blood pressures and increasing proteinuria. Glomerular histology at Week 48 revealed minimal inflammation, significant hypertrophy, and considerable sclerosis. We conclude that chronic, progressive renal disease can evolve after apparent recovery from an acute immunologic insult. Further study of this model should provide clinically relevant information about the mechanisms underlying this process.

Acute Disease↗
PubMed1991

Diuretic and natriuretic effects of sorbinil, an aldose reductase inhibitor.

The renal effects of sorbinil, an aldose reductase inhibitor that interferes with the conversion of glucose to sorbitol, were studied in rats and rabbits before and after fluid deprivation. The intracellular osmolar solute, sorbitol, is found in increasing concentrations from cortex to medulla in the kidney and may be involved in the urinary concentrating mechanism. Oral administration of sorbinil in the rabbit resulted in significant increases in urine flow rate and sodium excretion with a tendency toward decreased urine osmolality and increased potassium excretion both before and after water deprivation. When fluid intake was controlled in the rat study, significant increases in urine flow rate and sodium and potassium excretion and a significant decrease in urine osmolality occurred only in response to fluid deprivation. Thus, sorbinil has diuretic and natriuretic properties and may prevent the normal concentration of urine in the antidiuretic animal.

Aldehyde Reductase↗
PubMed1991

A simple method for percutaneous renal biopsy.

A technique for percutaneous renal biopsy in children is described which combines the use of ultrasound guidance and a disposable automatic biopsy device. Twenty-five biopsies in 22 children were performed using the Bard Monopty biopsy instrument. Adequate tissue was obtained to aid in diagnosis in 24 of 25 cases. Complications inclused 2 small perinephric hematomas. We conclude that the Bard Monopty biopsy device in association with ultrasonography provides for a safe and reliable technique to perform percutaneous renal biopsy in children.

Biopsy, Needle↗
PubMed1990

Glomerulocystic kidney disease: case report.

A newborn infant with abdominal masses was found to have Glomerulocystic Kidney Disease. Imaging showed markedly enlarged kidneys with multiple macroscopic cysts. Radiographic and clinical findings are discussed.

Humans↗
PubMed1990

Fluid needs in acute renal failure.

Derangements of fluid, electrolyte, and acid-base homeostasis are an inevitable part of acute renal failure. Understanding the pathophysiology of these disorders is essential to treating and preventing potentially life-threatening complications. Appropriate nutritional support is also an important part of management in childhood acute renal failure.

Acid-Base Imbalance↗
PubMed1990

Combination of metolazone and furosemide in the treatment of edema in the first month of life.

A combination of metolazone (0.2 mg/kg/day) and furosemide (4 mg/kg/day) was used in the treatment of a 2-week-old neonate who developed severe edema after cardiac surgery. The edema, which was initially responsive to furosemide, became resistant to high doses of this diuretic even with the concomitant use of ethacrynic acid. The addition of metolazone to furosemide induced prompt diuresis and natriuresis. This combination of diuretics can be helpful in the treatment of refractory edema in young infants.

Drug Therapy, Combination↗
PubMed1989

Colonic intussusception secondary to a calcium phosphate bezoar in a child receiving calcium carbonate for hyperphosphatemia.

We report a case of a calcium phosphate bezoar resulting in colonic intussusception in a boy with chronic renal failure who received calcium carbonate to control hyperphosphatemia. Because of concerns about aluminum-related disease in patients receiving aluminum hydroxide phosphate binders, calcium carbonate is being used more frequently to manage phosphate retention in renal failure. The development of bezoars may complicate this new form of therapy.

Bezoars↗
PubMed1989

Dietary protein restriction and renal injury in the spontaneously hypertensive rat.

We examined the influence of a low-protein diet on the course of the renal injury in spontaneously hypertensive rats (SHR) and SHR given antihypertensive drug therapy (SHRD). Antihypertensive drug treatment was hydralazine, reserpine, and chlorothiazide. Wistar-Kyoto (WKY) rats served as normotensive controls. SHR, SHRD, and WKY were each placed on a 24, 14, and 10% protein diet at 5 wk and followed to 80-90 wk of age. Untreated SHR showed a steady rise in protein excretion from 5 to 70 wk regardless of dietary protein content. Protein excretion in SHRD on a 24% protein diet was similar to untreated SHR. However, SHRD on a 14 or 10% diet had a more moderate increase in protein excretion. Glomerular, tubular, and vascular pathology in untreated SHR was not influenced by dietary protein intake. Despite successful antihypertensive therapy, kidney pathology in SHRD on a 24% diet was not significantly different from untreated SHR. In contrast, SHRD on 14 or 10% protein diets had less segmental glomerulosclerosis and vascular pathology than untreated SHR. The results indicate that dietary protein restriction does not influence the course of renal injury in untreated SHR. However, the combination of antihypertensive drug therapy with protein restriction in SHR delays and may arrest progression of glomerulosclerosis and proteinuria.

Animals↗
PubMed1988

Age-related changes in serum proteins of the spontaneously hypertensive rat.

Urinary protein excretion and composition in spontaneously hypertensive rats (SHR) change dramatically with age and sex. In this study, serum proteins were analyzed by electrophoresis in male and female SHR and Wistar-Kyoto (WKY) normotensive controls aged 5 to 80 weeks. Serum albumin concentrations of SHR were significantly higher than those of WKY at 5 (4.02 +/- 0.24 vs 3.60 +/- 0.25 g/dl) and 20 weeks (4.30 +/- 0.30 vs 3.77 +/- 0.31 g/dl) and significantly lower at 73-80 weeks (2.73 +/- 0.33 vs 3.45 +/- 0.34 g/dl). In addition, male SHR had significantly lower albumin levels than female SHR after 40 weeks of age. These differences may contribute to the development of hypertension and reflect the appearance of pathologic proteinuria in SHR. In spite of their differences in albumin concentrations, the fractional composition of serum protein from SHR and WKY were undistinguishable. All animals, regardless of strain or sex, manifested a significant decline in the relative amounts of albumin and low molecular weight protein and a significant increase in the relative amount of high molecular weight protein with increasing age. The etiology and significance of these age related changes in the fractional composition of serum protein are unknown, but they differ from the normal developmental pattern in humans.

Aging↗
PubMed1987

Renal effects of atrial natriuretic factor in domestic fowl.

The renal hemodynamic and tubular effects of ANF were investigated using the Sperber technique in chickens. This technique takes advantage of the unique portal circulation of the avian kidney and permits direct access to the renal peritubular space independent of renal arterial blood flow and glomerular filtration. Infusion of ANF into the avian renal portal system increased urine flow rate and sodium excretion by as much as 300% and 100%, respectively. These changes occurred in the absence of significant alterations in glomerular filtration rate or renal plasma flow. There was no significant difference in urine flow, sodium excretion or glomerular filtration rate between the ANF-infused kidney and the contralateral, non-infused kidney. We conclude that the diuretic and natriuretic effects of ANF do not depend on changes in glomerular filtration rate and that the site of action of ANF is the renal medulla.

Animals↗
PubMed1987

Hereditary partial deficiency of the third component of complement associated with minimal change nephrotic syndrome.

We describe a 10 year old patient admitted to the Children's Hospital of Buffalo with hypocomplementemia associated with steroid responsive minimal change nephrotic syndrome. The sibling also had a low serum C3 concentration and all family members studied had C3 slow phenotypes. Factor I levels were at the lower limit of normal in the patient and his brother. Functional assays for CH50, total hemolytic C3 and serum concentration of C2, C4-C9 and factors B and H were all within normal limits. This case confirms that a depressed serum complement level can occur in minimal change nephrotic syndrome and indicates that this depression could represent a preexisting inherited rather than an acquired deficiency. The findings are consistent with the presence of a null or hypomorphic C3 slow allele in hypocomplementemic family members. Additional studies are needed to resolve the association between the inherited partial C3 deficiency and minimal change nephrotic syndrome.

Child↗