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PubMed1987

Xanthogranulomatous pyelonephritis in a functioning kidney. A case report.

A 34-year-old woman with xanthogranulomatous pyelonephritis mimicking a renal tumour is presented. Preoperative examinations including renal ultrasonography, computed tomography, renal angiography and fine needle biopsy could not exclude malignancy. The diseased kidney had good function and there was no history or signs of urinary tract infection or calculi. During operation a frozen section biopsy showed xanthogranulomatous pyelonephritis and a kidney-saving enucleation of the tumour was performed. The patient recovered uneventfully with good kidney function on the operated side.

Adult↗
PubMed1983

Relationship of kidney function to immunopathology in chronic serum sickness of rats.

This study sought to clarify the relationship between kidney function and immunopathology in chronic serum sickness (CSS) of rats. CSS was induced by chronic intravenous immunization with bovine serum albumin. Whole kidney function was studied during the course of CSS by assays of serum and urine. Single nephron function was evaluated by micropuncture techniques. Three categories (mild, moderate, severe) of kidney disease were identified from the analysis of kidney function in rats with CSS. Those categories represented distinct stages in the natural history of CSS nephritis. The three stages identified by measurements of function corresponded to distinct categories of kidney immunopathology. In rats with milk CSS, immune deposits were limited to the mesangium; histopathology was slight or absent. The only detectable change in protein handling was a small elevation of albumin concentration in tubule fluid. Abnormal proteinuria was a feature of moderate CSS; whole kidney glomerular filtration was not decreased despite evidence of significant immunopathology of glomeruli. Compromise of whole kidney function including decreased sodium excretion was only detected in the severe stage of CSS in association with diffuse proliferative glomerulonephritis. The transitions from mild to moderate and moderate to severe CSS were not gradual but occurred as discrete, sudden events.

Animals↗
PubMed1991

Acute changes in renal function following extracorporeal shock wave lithotripsy in patients with a solitary functioning kidney.

Twelve consecutive patients with a solitary functioning kidney were treated for renal stone by extracorporeal shock wave lithotripsy (ESWL*) with the modified Dornier HM3 lithotriptor and studied for 3 days after treatment. Urinary excretion of electrolytes, N-acetyl-beta-glucosaminidase (NAG), alkaline phosphatase, kallikrein, glycosaminoglycans, albumin and beta 2-microglobulin, and clearances of creatinine, inulin and para-aminohippuric acid were determined, as were serum levels of creatinine, urea, beta 2-microglobulin and aldosterone, and plasma renin activity. Urinary flow rate, free water clearance, and urinary excretion of NAG, kallikrein and beta 2-microglobulin were significantly increased 0 to 24 hours after ESWL. The urinary excretions of alkaline phosphatase, albumin and glycosaminoglycans were unchanged. Glomerular filtration rate was significantly decreased and effective renal plasma flow was unchanged. Filtration fraction was stable. Serum lactic dehydrogenase increased significantly after ESWL and remained high through the period of observation. Serum levels of creatinine, beta 2-microglobulin and aldosterone were unaltered. A decrease in plasma renin activity immediately after treatment is explained by the water immersion and the extracellular volume expansion during treatment.

Female↗
PubMed1979

Lithium treatment and kidney function. A survey of 237 patients in long-term treatment.

Kidney function has been examined in 237 patients who in the autumn of 1977 were in lithium treatment at the Psychiatric Hospital in Risskov, most of them as outpatients. The average age was 42 years. The patients had been given lithium treatment for 0.5-17 years, mean duration 5 years. The mean lithium dosage was 33 mmol/day and the mean 12-hour serum lithium concentration 0.85 mmol/l. Glomerular filtration rate was assessed through determination of 24-hour creatinine clearance and serum creatinine, in some cases iothalamate clearance. Water excretion was assessed through determination of 24-hour urine volume and in some cases urine osmolality after 26 hours of fluid deprivation. Creatinine clearances, serum creatinine concentrations, and urine volumes were subjected to multiple regression analysis with various clinically relevant predictor variables. Affection of glomerular filtration rate was only moderate and progressed slowly. The data indicate that the risk of renal insufficiency and terminal azotemia is remote even when lithium is given for many years. A large number of the patients had altered water excretion with polyuria or lowered urine concentrating ability or both. Due to the extra fluid loss these patients are apt to develop dehydration, and they may then be in danger of lithium poisoning. We hypothesize that lithium-induced changes of kidney function may become less frequent and less pronounced if patients are maintained at serum lithium levels somewhat lower than those employed in the group studied here. We recommend careful monitoring of serum lithium levels, regular control of kidney function, and extra caution when physical illness or additional drug treatment may lead to disturbance of fluid and electrolyte balance.

Adult↗
PubMed1983

Kidney function in an unselected lithium population. A cross-sectional study.

We studied kidney function in 124 short-term and long-term lithium outpatients from a population of 127 patients. Glomerular and distal tubular function were measured and correlated with a number of demographic and treatment variables. There was a significant negative correlation between age and glomerular filtration rate. There were no other significant correlations. Tubular function was below normal in 51% of the patients. Glomerular function was below normal in 3% of the patients. We conclude that lithium treatment in non-toxic dose affects kidney function and that tubular function is more affected than glomerular function. Tubular function probably is better than our figures indicate, glomerular function not as good. Types of lithium preparation do not affect kidney function differently nor does combined treatment with neuroleptics.

Adult↗
PubMed1992

Long-term partial ureteral obstruction and its effects on kidney function.

Previously it has been shown that partial ureteral obstruction present in young rats for 12 weeks results in small morphological changes in the kidney as well as slightly decreased kidney function. In the present study the aim was to examine whether rats obstructed for one year had more advanced changes in morphology and kidney function. The first group of animals examined after three weeks of obstruction showed only modest changes in kidney function with a reduced potassium concentration in the urine but no reduction in the glomerular filtration rate. After one year there was a reduction in urine flow as well as in the excretion of both potassium and sodium. Urine osmolality was also reduced. Glomerular filtration rate measured in this group of animals was reduced in the obstructed kidney by about 60% compared to the contralateral one. There were only small changes in the morphology with no loss in parenchymal weight or compensatory hypertrophy, but there was a significant deformation of the papilla and an increase in inflammatory cells in the parenchyma. In conclusion hydronephrosis during a shorter period is not harmful to kidney function but if sustained for an extended time period kidney function will deteriorate.

Animals↗
PubMed1991

[Kidney function of patients with healthy kidneys during cyclosporin treatment].

Long-term administration of ciclosporin has been complicated by side-effects, the predominant being nephrotoxicity. We performed renal function studies on 20 patients treated with ciclosporin (group 1) and on 12 patients serving as controls (group 2). Only patients with serum creatinine less than 1.3 mg/dl entered the study. The renal function studies consisted of: Inulin clearance, PAH clearance, sodium sulphate loading, sodium bicarbonate loading. Plasma renin activity (PRA), inactive renin (IR) and aldosterone (ALDO) were measured basally and after stimulation with 40 mg furosemide i.v. Serum creatinine was not significantly impaired under ciclosporin with 1.1 +/- 0.1 mg/dl vs 0.9 +/- 0.1 mg/dl in the control group (ns). Glomerular filtration rates as measured by creatinine and inulin clearance were significantly impaired in group 1 as compared to group 2. Inulin clearance was impaired by ciclosporin with 93.5 +/- 4.4 ml/min/1.73 m2 as compared to 121 +/- 6.6 ml/min/1.73 m2 (p less than 0.05) in patients of group 2. The PAH clearance in ciclosporin treated patients was impaired, with 379 +/- 22.1 ml/min/1.73 m2 in group 1 as compared to 605 +/- 39 ml/min/1.73 m2 (p less than 0.001) in group 2. Mean arterial pressure and renovascular resistance were significantly increased in ciclosporin treated patients. We demonstrated, by means of sodium sulphate and bicarbonate loading, incomplete distal tubular acidosis in 3 patients from group 1 but in none of group 2. There was no difference in basal plasma renin activity (PRA), but during volume contraction induced by furosemide there was only blunted response by PRA in patients receiving ciclosporin with 2.7 +/- 0.3 ng/ml/h as compared to 7.7 +/- 0.5 ng/ml/h in controls.(ABSTRACT TRUNCATED AT 250 WORDS)

Acid-Base Equilibrium↗
PubMed1976

The non-functioning kidney in renal tuberculosis.

The authors have found a non-functioning kidney in 117 patients, constituting more than 24 per cent of 487 patients with bacteriologically and/or histologically confirmed renal tuberculosis, treated and followed up in the last ten years. In 2/3 of the patients with non-functioning kidney and renal tuberculosis, the conditions of non-functioning had been already present from the very beginning, at the time when renal tuberculosis was established. In the remaining 1/3 of the patients, one of the kidneys had ceased to function in the course of treatment. The authors found that the main causes for the failure of the kidney function in renal tuberculosis are strictures of the draining urinary pathways. Emphasis is laid upon the necessity of a careful observation of the patients with renal tuberculosis in the course of drug treatment in view of a timely detection and treatment ofthe strictures in the draining urinary pathways.

Adult↗
PubMed1976

[The contribution of nephro-urotomography in the diagnosis of unilateral non-functioning kidney in the adult (author's transl)].

The aetiological diagnosis of a unilateral nonfunctioning kidney is achieved by angiographic or retrograde techniques. Pyelography indicates only that organ is non-functioning. 71 patients were explored by nephro-urotomography carried out using high doses of contrast medium (2 cm3/kg) with rapid injection (10cm3/sec.) and repeated tomographic sections taken during the first minute after injection. These tomographic sections, three in number, made it possible to study the three phases of the nephrogram: cortical nephrography, cortico-medullary nephrography and tubular nephrography. The aim of this study was to assess the contribution of this technique in the aetiological diagnosis of a unilateral non-functioning kidney. In the majority of cases it is possible to suspect the vascular or neoplasic origin of the non-functioning kidney. Obstructive non-functioning kidneys have two distinct nephrographic appearances. Pelvic and retroperitoneal obstructions are visualised chiefly during the phase of cortical nephrography, which shows marked parenchymatous atrophy with the presence of rounded intrarenal lacunae. By contrast, obstruction secondary to pyelo-ureteral junction syndrome results in total destruction of the parenchyma. The phenomenon of total corporeal opacification plays a major role in the visualisation of the fibrous speta which form the limits of the pseudocystic pockets. In these patients, the contribution of study of early nephrograms is less evident. Bacillary non-functioning kidneys have an analogous appearance characterised by the particular frequency of abnormal opacities, calcified ormastic. Thus the aetiological diagnosis of a unilateral nonfunctioning kidney may be obtained in the majority of cases. This permits more judicious selection of those cases requiring angiography or retrograde exploration necessary to pre-operative assessment.

Humans↗
PubMed1985

The individual kidney function. A comparison between frame summation and deconvolution.

A variety of methods have been developed to estimate the individual kidney function. Many methods use a scintillation camera the data from which are processed in a computer system. To compare two of these methods, the principles of which are completely different, such as the 'Oberhausen' method of frame summation and background subtraction and a method that uses deconvolution, the scintillation camera data of 121 patients have been collected. A computer program was written to calculate the individual kidney function by which both methods were used. It is often asserted that specific techniques of frame summation and background subtraction are not suitable to define the individual kidney function. To see if this assertion is true, two different methods have been compared using the contribution of the left kidney to the individual kidney function. An excellent correlation between the two methods was found (R = 0.9808, n = 121) which proves the ability of both the 'Oberhausen' method and the method that uses deconvolution. However, it is also seen that the 'Oberhausen' method may give false results, caused by an increasing background count outside the kidneys in patients with a large difference in function between the two kidneys.

Humans↗
PubMed1985

Recovery of kidney function after cessation of graft function or prolonged dialysis treatment.

The occurrence of recovery of kidney function after cessation of graft function or prolonged dialysis treatment has been studied retrospectively, and the frequency was found to be roughly 1%, inasmuch as 8 of approximately 750 patients could dispense with dialysis after 10-131 weeks of treatment. The causes of recovery of kidney function are discussed, as the importance of keeping this possibility in mind.

Adult↗
PubMed1976

[Kidney function test after partial nephrectomy (author's transl)].

A new method for testing the function of the kidney after partial nephrectomy is reported. By means of radioisotope renography, urography and radioisotope clearance ('single-shot' method) it is possible to prove the function of the single kidney. The clearance in regard to the size of the shadow of the kidney assessed by urography allows to estimate the specified kidney function. We used these methods in ten patients and we detected that the loss of function is more extensive than expected by the operative reduction of the kidney parenchyma only. The causes for this are discussed.

Humans↗
PubMed1992

[Kidney function in pregnant women with hypertension in the course of chronic kidney disease].

In 53 pregnant patients in the III trimester of pregnancy kidney function investigations were carried. The group consisted of 23 patients with chronic kidney diseases with superimposed arterial hypertension (examined group) and of 30 healthy pregnant women (control group). In the examined group an increase of blood-serum urea, uric acid and creatinine concentrations were demonstrated. In these women the blood pH was decreased also. The urinary excretion of NH4+ and H+ ions was decreased, the excretion of Na+ and K+ was normal.

Female↗
PubMed1976

[Effect of kanamycin on kidney function in children with suppurative, inflammatory diseases].

The effect of kanamycin on the kidney function and the possibility of decreasing its side effect of pyrimidines were studied in240 children at the age of 2 month to 14 years (161 children with acute and chronic osteomyelitis and 79 children with staphylococcal destruction of the lungs). Kanamycin used in doses of 15000 and 25000 Units/kg of the body weight for 6 to 7 days in treatment of the children with staphylococcal destruction of the lungs, acute and chronic osteomyelitis had no nephrotoxic effect. Combination of kanamycin with pentoxyl, pryimidine derivative significantly improved the kidney function, which was evident from the content of the residual nitrogen in the blood serum and increased glomerural filtration. Combined use of kanamycin with pentoxyl promoted a decrease in albuminuria and leucocyturia. The data of the study provided recommendation of increased therapeutic doses of kanamycin, up to 15000--25000 Units/kg of the body weight in accordance with the recommendations under conditions of constant control of the kidney function.

Acute Disease↗
PubMed1991

Acute renal failure in critically ill patients: prognosis for recovery of kidney function after prolonged dialysis support.

OBJECTIVE: To clarify the prognosis for eventual recovery of kidney function in patients who experience prolonged dialysis dependence after acute renal failure (ARF). DESIGN: Retrospective, chart review. SETTING: Inpatients of a large, referral-based hospital. PATIENTS: Twenty-six consecutive survivors of ARF who required greater than 4 wk of dialysis support. RESULTS: All 26 patients were critically ill and developed ARF during treatment in an ICU. The clinical course of these patients was characterized by multiple episodes of renal ischemia or nephrotoxin exposure during dialysis dependence. However, despite multiple renal insults and prolonged dialysis support (mean duration 8.4 +/- 0.7 wk), 23 (88%) of the 26 patients recovered sufficient kidney function to discontinue dialysis. Preexisting renal impairment was associated with a greater risk of irreversible renal failure, and, in patients able to discontinue dialysis, renal recovery was often incomplete. CONCLUSIONS: Despite some renal damage, most critically ill patients who survive ARF requiring prolonged dialysis support recover life-sustaining kidney function.

Acute Kidney Injury↗