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Results for “kidney function”

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PubMed1990

On the natural tendency to progressive loss of remaining kidney function in patients with impaired renal function.

Patients who lose more than 50% of their functioning renal mass are at risk to develop progressive deterioration of their remaining kidney function, even though the process that caused the original loss of kidney function may no longer be present. The glomerular capillary hyperperfusion, hypertension, and hyperfiltration that occur in the surviving nephrons may play an important role in the natural tendency for renal function to deteriorate. Nevertheless, recent studies suggest that these glomerular hemodynamic events may not be the final common pathway for the natural deterioration of renal function, as was once thought. With regard to the general management of patients with impaired renal function, recent evidence suggests that controlling systemic blood pressure, reducing dietary protein and phosphorus intake, and controlling hyperlipidemia may be effective in slowing the loss of renal function.

Hormones↗

PubMed1988

Effect of blood purification on the kidney function of the jaundiced rat.

This paper is aimed at evaluating the effect of blood purification on the mitochondrial functions of the kidney in jaundiced rats. At 1, 2, or 3 weeks after bile duct ligation and dissection, obstructive jaundiced rats were utilized for experiment. Cross circulation in 1 ml/min between jaundiced rats and normal rats was performed for 1 or 3 h. Immediately and 24 h after cross circulation, the rats were killed and mitochondrial respiratory functions of the kidney were assessed by measuring oxygen consumption. Mitochondrial function, especially ATP synthesis, showed significant improvement in jaundiced rat with 2 or 3 weeks of biliary obstruction. Cross circulation for 3 h was more effective than that for 1 h. These data suggest that the renal energy production can be increased significantly in obstructive jaundice by blood purification treatment.

Animals↗

PubMed1985

[Artificial respiration and kidney function disorder--a vicious circle?].

Acute lung disease is commonly associated with interstitial pulmonary edema and a tendency towards partial or total alveolar collapse. To counteract this tendency mechanical ventilation is successfully used in most cases. Mechanical ventilation, however, leads to a harmful retention of water and salt, which may worsen interstitial pulmonary edema and further impair gas exchange. This problem seems to be less known. A survey of the effects of currently used modes of mechanical ventilation on excretory function and hemodynamics of the kidneys is given together with a short review of the possible afferent and efferent mechanisms which mediate the renal response to mechanical ventilation. Some clinical suggestions are made to break through the vicious cycle between mechanical ventilation and kidney function.

Animals↗

PubMed2003

Outcome of patients with continent urinary reconstruction and a solitary functioning kidney.

OBJECTIVE: To evaluate the outcome of patients with continent urinary diversions who had a solitary functioning kidney at the time of surgery. PATIENTS AND METHODS: In all, 62 patients with continent urinary reservoirs and a solitary functioning kidney were reviewed (51 men and 11 women). The indications for surgery were bladder cancer in 54 and a contracted bladder in eight. The surgical procedures included an orthotopic ileal neobladder in 36 patients, a continent cutaneous ileal reservoir in 13 and rectal diversion in 13. Kidneys were evaluated using serum creatinine level, ultrasonography, intravenous urography and other radiological studies. RESULTS: The follow-up was 6-173 months; 44 renal units (71%) remained stable during this period. Serum creatinine was increased in four patients with an orthotopic neobladder, with no evidence of obstruction or reflux, in one with preoperative renal impairment and one with voiding dysfunction, reflux and bacteriuria. Six renal units deteriorated because of uretero-intestinal strictures; of these patients, two were treated endoscopically, two with open ureteric reimplantation, one with conversion from a rectal reservoir to an ileal loop conduit, and one was maintained on JJ stenting. Six patients with a rectal diversion had renal deterioration because of chronic pyelonephritis. CONCLUSIONS: A regular follow-up of renal function is mandatory in patients with a continent urinary diversion. Rectal diversion is associated with a higher risk of renal deterioration (54%) than are orthotopic (28%) and cutaneous reservoirs (8%).

Adolescent↗

PubMedDate not supplied

Early detection of changes in kidney function in workers exposed to solvents and heavy metals.

Increases in urine concentration of specific proteins have been proposed as early indicators of deleterious changes in kidney function. Four urinary proteins (albumin, superoxide dismutase, transferrin and N-acetyl-beta-D-glucosaminidase) were measured in workers exposed to heavy metals and solvents. None of the workers had clinical evidence of renal disease or hypertension. Workers exposed to mercury had a significant increase in urinary transferring, superoxide dismutase levels were slightly increased in workers exposed to solvents and lead, follow-up of these workers is needed to confirm that these changes predict late clinical deterioration of kidney functions.

Chemical Industry↗

PubMed2006

Kidney function predicts the rate of bone loss in older individuals: the Cardiovascular Health Study.

BACKGROUND: Results of cross-sectional analyses of the association of kidney function with bone mineral density (BMD) have been conflicting. We examined the association of cystatin-C, a new marker of kidney function that is unrelated to lean mass, with initial and follow-up BMD, in an ancillary study of the Cardiovascular Health Study, a population-based cohort of individuals > or = 65 years old. METHODS: Two years after measurement of cystatin-C and other covariates, the first BMD was measured in Pittsburgh, Pennsylvania and Davis, California, by using dual energy x-ray absorptiometry. Follow-up BMD was measured in Pittsburgh 4 years later. Associations of cystatin-C with initial BMD and the change in BMD (%/y) at the hip were examined with linear regression. Analyses were conducted separately for men and women. RESULTS: In 1519 participants who had cystatin-C and initial BMD assessed, 614 had follow-up BMD. The percent annual change in BMD at the total hip by cystatin-C quartiles was -0.24, -0.13, -0.40, and -0.66%/y (first to fourth quartile) in women and -0.02, -0.30, -0.18, and -0.94%/y in men. After adjusting for potential confounders, cystatin-C was marginally associated with initial BMD in men but not women. Cystatin-C was associated with bone loss in men; after adjustment for weight loss, cystatin-C was not associated with bone loss in women. CONCLUSION: Kidney dysfunction, as assessed by cystatin-C, is associated with a more rapid loss of BMD at the hip, especially in men. Further studies are needed to confirm these findings and to determine whether this loss leads to an elevated risk of fracture.

Absorptiometry, Photon↗

PubMedDate not supplied

[The surgical treatment of staghorn nephrolithiasis in children and its effect on kidney function].

29 children with coral nephroliths were examined by dynamic nephroscintigraphy before surgery, after it and on postoperative month 6-24. The patients whose age ranged from 5 to 15 years underwent sectional nephrolithotomy (22 cases) or partial nephrolithotomy (7 cases). The findings led the authors to the following conclusions: the reduction in the renal function following sectional nephrolithotomy is inversely proportional to preoperative functional deficiency of the affected kidney; application of partial and sectional nephrolithotomy in children with coral and multiple nephroliths is justified only in case of contraindications to extracorporeal impulse lithotripsy; sectional nephrolithotomy in children with coral nephroliths is indicated in initial deficiency of the affected kidney function more than 50%.

Adolescent↗

PubMed1992

Comparison of effective renal plasma flow (ERPF) and endogenous creatinine clearance (Ccr) in evaluation of the differential kidney function: an in vivo study.

Eleven patients with obstructive uropathy were inserted with a pigtail catheter either for urinary diversion, endopyelotomy or percutaneous nephrolithotomy. Differential kidney functions were obtained by single-sample technique with I-131 orthoiodohippurate (OIH) and separate endogenous creatinine clearance (Ccr). Good linear correlation was noted between effective renal plasma flow (ERPF) and Ccr (r = 0.84, p less than 0.005), but there was still some discrepancy between these two examinations, chiefly found in two severely obstructed kidneys. Determination of ERPF by I-131-OIH single-sample technique is a simple, rapid, inexpensive and relative accurate test to measure the differential kidney function. But if the ERPF is at extremely low level, further investigations such as sonography of kidney and separate endogenous creatinine clearance should be done to avoid unnecessary nephrectomy.

Adolescent↗

PubMed1984

Effect of different linoleic acid intakes on prostaglandin biosynthesis and kidney function in man.

Prostaglandin (PG) biosynthesis and kidney function was investigated in 24 adults (23 to 32 yr) during isocaloric formula diet periods, for 2 wk each, providing a linoleic acid supply of 0, 3, 3.5, 4, 6, 8, 13, 17, 18, or 20% of total energy intake. Total protein intake (15 energy %) was constant, as well as 5 g NaCl, 3 g KCl, and 0.6 g cholesterol per 2200 kcal formula diet. The amount of PG metabolites, PG-E, sodium, and creatinine in 24-h urine increased with augmented linoleic acid intake. Comparing a linoleic acid intake of 0 and 20 energy %, an increase of sodium (8%) and creatinine (16%) in 24-h urine was found on the 5th day of high linoleic acid supply. Coincidently a stimulated PG biosynthesis could be measured. Potassium, water, and PG-F excretion showed no relation to linoleic acid intake. It is concluded that linoleic acid in the diet stimulates PG-E biosynthesis in man, leading to effects in systems which control renal function, and may have clinical relevance for the sodium and potassium balance in man.

Adult↗

PubMed1977

[Changes of kidney function in obese subjects during absolute fasting (author's transl)].

In 28 obese subjects the influence of a 15-days fasting period on the kidney function was investigated by continuous measurement of the clearances for creatinine, urea and uric acid. In the course of fasting time the serum concentrations of creatinine in comparison to the initial value significantly increased, the creatinine clearance maximally decreased about 40%. The serum concentrations of urea were found lower, whilst the clearance of urea increased. Moreover a distinct increase of the serum levels in connection with a significant decrease of the uric acid clearance was to be observed. Under conditions of strict fasting changes of the kidney function are evident, whose intra- and extrarenal reasons are discussed.

Adult↗

PubMedDate not supplied

Laboratory assessment of kidney function.

It is important to be able to accurately predict the function of the kidneys by estimating GFR. GFR is a strong predictor for the onset and complications of CKD and it also allows us to dose-adjust medications. It, unfortunately, cannot be measured directly, so we have to depend on surrogate markers such as creatinine to estimate it. With the development of newer predictive equations such as the MDRD equations, we can more accurately estimate GFR in certain populations.

Adult↗

PubMed1987

[Specific features of postoperative infusion therapy depending on kidney function in newborn infants with developmental defects].

Results of examination of partial functions of the kidneys in 113 newborns have shown the reaction of the kidneys on a surgical aggression to be dependent on the age and stage of the postoperative period. The reaction manifests itself by renal economy of water and electrolytes on the 1-3 days after operation followed later by the osmotic dilution of urine and lower reabsorption of sodium and potassium. The maximum amount of sodium admissible for administration in the postoperative period has been established with special reference to age.

Age Factors↗

PubMed1981

[Kidney function disorders in "uncomplicated" skeletal trauma in children].

The renal function was studied in 198 children with non-complicated skeletal trauma (fraction of the femur, vertebral column and others). The renal function was found to be disturbed in 34,3% of the cases. The suitable treatment results in normal functioning of the kidneys within the 2nd week after trauma.

Child↗

PubMed2004

Kidney function is inversely associated with coronary artery calcification in men and women free of cardiovascular disease: the Framingham Heart Study.

BACKGROUND: Among patients with end-stage renal disease (ESRD), the risk of cardiovascular disease is 10 to 20 times higher than the general population. Adults with ESRD have increased coronary-artery calcification (CAC) detected by electron-beam computed tomography (EBCT). Because the risk of coronary heart disease is increased even at moderate declines in kidney function, we sought to test whether high CAC scores are seen among those with mild reductions in kidney function. METHODS: Men and women free of symptomatic cardiovascular disease underwent EBCT. Coronary calcium was quantified using the method described by Agatston. Renal function was estimated by glomerular filtration rate (GFR). Spearman correlation coefficients were used to test the association between GFR and CAC. RESULTS: Three hundred nineteen subjects (162 men/157 women), mean age 60, were included. Mean GFR was 86 +/- 23 mL/min/1.73 m2 (range 31-169; 10% with GFR <60 mL/min/1.73 m2). The median CAC scores by quartile of GFR were 85.9, 48.1, 7.9, and 2.7. Overall, the unadjusted correlation of GFR and CAC was -0.28 (P < 0.0001). This remained significant after adjustment for age and sex (-0.11, P < 0.05), and additionally after adjustment for body mass index (-0.11, P < 0.05), hypertension (-0.11, P < 0.05), or total cholesterol (-0.12, P= 0.04). A similar correlation was noted after multivariable adjustment (-0.10, P < 0.08). CONCLUSION: Mild declines in kidney function are associated with subclinical coronary artery calcification in a sample of subjects free of clinically apparent cardiovascular disease. This might help explain the increased risk of cardiovascular disease among individuals with renal dysfunction. Larger ongoing studies are needed to better quantify this finding.

Adult↗

PubMed1991

Comparative effects of enalapril, atenolol and chlorthalidone on blood pressure and kidney function of diabetic patients affected by arterial hypertension and persistent proteinuria.

Arterial hypertension and proteinuric nephropathy are common features in diabetic patients. In streptozotocin-diabetic rats, it has been possible to reduce the blood pressure and proteinuria by converting enzyme inhibitors, and so slowing the decline of kidney function. These results have been confirmed in diabetic patients affected by arterial hypertension and persistent proteinuria. However, up to now it has not been clear if these favorable renal effects are related specifically to converting enzyme inhibition. In the attempt to clarify this last point, from a practical as well as from a speculative point of view, 12 type 2 diabetic outpatients affected by mild to moderate arterial hypertension and persistent macroalbuminuria (greater than 250 mg/daily, at least on three consecutive occasions) without any other signs of renal diseases were studied. In a randomized sequence and in a double blind fashion, after a washout period of 3 weeks, the patients underwent pharmacological treatment which consisted of enalapril 20 mg o.d., chlorthalidone 12.5 mg o.d., atenolol 50 mg o.d. and placebo o.d. Each treatment lasted 45 days. Kidney function, blood pressure and heart rate were checked at the beginning and at the end of each treatment, while urinary albumin excretion was measured at the end of the 4th, 5th, and 6th week of each treatment. Blood pressure significantly decreased in a similar fashion after each active treatment, while kidney function did not change significantly. Urinary albumin excretion rate significantly decreased after enalapril and atenolol, but did not change after chlorthalidone. According to these results we can hypothesize that the inhibition of tissue angiotensin formation and its related change on the glomerular permeability, rather than renal and systemic hemodynamic features, seem to be the common mechanisms by which both enalapril as well as atenolol decrease the albuminuria in our patients.

Atenolol↗

PubMed2004

Atherosclerotic renal artery stenosis: one year outcome of total and separate kidney function following stenting.

BACKGROUND: Renal artery stenosis (RAS) is a known cause of hypertension and ischemic nephropathy. Stenting of the artery is a valid approach, in spite of cases of unexpected adverse evolution of renal function. METHODS: In this study, 27 patients with unilateral RAS were subjected to stenting and followed for a period of one year, while 19 patients were observed while on medical treatment only. The group of 27 patients, 67.33 +/- 6.8 years of age, creatinine of 2.15 +/- 0.9 mg/dl, following stenting, were followed at intervals with biochemical tests, renal scintigraphy and doppler ultrasonography. The control group (70.0 +/- 6.1 years, creatinine 1.99 +/- 0.7 mg/dl) was also followed for one year. RESULT: One year after stenting mean creatinine clearance (Ccr) increased from 36.07 +/- 17.2 to 40.4 +/- 21.6 ml/min (NS). Arterial BP, decreased after 1,3,6, and 12 months (p < 0.05). The number of antihypertensive drugs also decreased (p < 0.05). A significant increase in proteinuria was also observed. In the control group both Ccr, BP and proteinuria did not show significant changes. Based on renal scintigraphy and Ccr at subsequent times, it was possible to evaluate the timecourse of renal function in both kidneys of the stented patients. In the stented kidneys Ccr increased significantly. On the controlateral kidney a decrease of renal function (p < 0.05) was observed. Resistance index appeared to be a risk factor of the functional outcome. CONCLUSIONS: Stenting of RAS due to atherosclerosis is followed by stabilization or improvement of Ccr, mainly at the stented kidney, while contralateral renal function showed a decrease.

Aged↗

PubMedDate not supplied

Medical multiparametric time course prognoses applied to kidney function assessments.

In this paper, we describe an approach to utilize case-based reasoning methods for trend prognoses for the monitoring of the kidney function in an Intensive Care Unit (ICU) setting. Since using conventional methods for reasoning over time does not fit for course predictions with poor medical knowledge of typical course patterns, we have developed abstraction methods suitable for integration into our case-based reasoning system ICONS. These methods combine medical experience with prognoses of multiparametric courses. On the ICU, the monitoring system NIMON provides a daily report based on current measured and calculated kidney function parameters. Subsequently, we generate course-characteristic trend descriptions of the renal function over the course of time. Using case-based reasoning retrieval methods, we search in the case base for courses similar to the current trend descriptions. Finally, we present the current course together with similar courses as comparisons and as probable prognoses to the user. We applied case-based reasoning methods in a domain which seemed reserved for statistical methods and conventional temporal reasoning.

Artificial Intelligence↗

PubMed1998

Prognoses of multiparametric medical time courses applied to kidney function assessments.

In this paper, we describe an approach to utilize Case-Based Reasoning methods for trend prognoses for the monitoring of the kidney function in an Intensive Care Unit (ICU) setting. Since using conventional methods for reasoning over time does not fit for course predictions with poor medical knowledge of typical course patterns, we have developed abstraction methods suitable for integration into our Case-Based Reasoning system ICONS. These methods combine medical experience with prognoses of multiparametric courses. On the ICU, the monitoring system NIMON provides a daily report based on current measured and calculated kidney function parameters. We subsequently generate course-characteristic trend descriptions of the renal function over the course of time. Using Case-Based Reasoning retrieval methods, we search in the case base for courses similar to the current trend descriptions. Finally, we present the current course together with similar courses as comparisons and as possible prognoses to the user. We applied Case-Based Reasoning methods in a domain which seemed reserved for statistical methods and conventional temporal reasoning.

Artificial Intelligence↗