[When a limited budget exists, which will it be: hemodialysis or renal transplant?].
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Biomedical subjects
Publications and source records attributed to O L Ramos.
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Saralasin (S) infusion, at a dose of 10 micrograms/kg/min IV, decreased Glomerular Filtration Rate (GFR) in 18 hypertensive patients. This effect was more pronounced in those patients with angiotensinogenic hypertension due to the somation of the effects of S upon renal vasculature and systemic arterial pressure. A decrease in urinary sodium excretion was also observed being more intense in those patients whose systemic pressure also decreased during S infusion. In group II (10 hypertensive patients) infusion of S in increasing doses (0.1, 0.5, 1.0, 5.0 and 10.0 micrograms/kg/min) a progressive decrease in GFR was observed only when the arterial pressure also decreased. However urinary sodium excretion decreased progressively as S doses increased. This effect was not related to S effect upon arterial pressure. This observation indicates that S, like angiotensin II, has a direct effect upon the renal tubules evoking an increase of sodium reabsorption.
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Five obese subjects were studied during prolonged starvation. Then renin aldosterone system and urinary aldosterone excretion were studied during prolonged starvation and refeeding in five obese subjects. An uniform increase in aldosterone urinary excretion was observed in all subjects studied. A progressive increase in renin plasma activity was found in all patients along the starvation period with a striking additional increase after refeeding. The possible factors involved are discussed.
The effect of progressive increase in hematocrit on urinary sodium excretion was studied in normal and uremic dogs submitted to expansion of the extracellular fluid volume. In normal dogs concomitant with hematocrit increases it was observed a decrease in urinary sodium excretion. On the other hand in uremic dogs submitted to the same experimental conditions it was verified an increase in urinary sodium excretion.
Three days after creating an access to the turcica on the sphenoid bone, twelve anesthetized mongrel dogs, after control collections, were submitted to extracellular volume expansion with saline. Thereafter, maintained constant the rate of saline infusion, the dura-mater covering the pituitary gland was incised in all dogs, the hypohysis being removed in seven and remaining untouched in the other five dogs. Pharmacological doses of pitressin, glycocorticoids and mineralocorticoids were administered to all dogs. It was shown, for the same filtered sodium load(p is greater than 0.05), that hypophysectomy produces a significant reduction (p is less than 0.05) in urinary sodium excretion previously elevated by the extracellular volume expansion, while durostomy only, without removal of th hypophysis, did not change (p is greater than 0.05) the rate of sodium excretion. Thus, the pituitary gland could be considered as contributing to natriuresis during extracellular volume expansion, all other factors related to this expansion remaining constant in both, hypophysectomized and sham operated dogs.
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