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PubMed1975

Reconsideration of split kidney function tests in hypertension: a new technique.

The role of the split kidney function tests in the diagnosis of renal hypertension is reviewed, and a new technique is described which is designed to diminish the number of false negative results sometimes encountered in unilateral pyelonephritis and segmental renal arterial stenosis. Split kidney function tests still have an important role in diagnosis of renal hypertension, particularly when the results of other investigations are equivocal and when facilities for differential renal renin assay are not available.

Aortography↗
PubMed1979

[Hypothermic storage under aerobic conditions--the effect of different flushing solutions on kidney functional recovery].

Canine kidneys (n = 17) were flushed with COLLINS (C2), SACKS II, LAMBOTTE (KMgS), ROSS (hypertonic citrate), or RINGER glucose-mannitol solution following a 30-min period of normothermic ischemia. After 24 h hypothermic preservation with retrograde oxygen persufflation (ROP) and autotransplantation, the immediate functional recovery was determined using inulin and PAH clearance methods and compared with the normal contralateral kidney. While a good functional recovery was found in the COLLINS group, significantly exceeding results from hypothermic ischemic storage preservation, in experiments using other flush solutions ROP preservation resulted in only a small immediate function. Thus the experiments indicate that COLLINS solution C2 is the optimal flush solution for ROP preservation.

Aerobiosis↗
PubMed1994

Impact of lisinopril and atenolol on kidney function in hypertensive NIDDM subjects with diabetic nephropathy.

Diabetic nephropathy is characterized by hypertension and a relentless decline in kidney function. Angiotensin-converting enzyme inhibitors have been claimed to preserve kidney function better than an equal blood pressure (BP) reduction with conventional antihypertensive treatment (renoprotection). We compared the effect on kidney function of lisinopril (10-20 mg/day) and atenolol (50-100 mg/day) in hypertensive NIDDM patients (mean age 60 +/- 8 years) with diabetic nephropathy. Forty-three (21 lisinopril and 22 atenolol) patients were enrolled in a 1-year randomized double-blind parallel study. Eight patients dropped out, and the results for the remaining 35 patients (16 lisinopril and 19 atenolol) are presented. Diuretics were required in 10 of 16 lisinopril patients and 12 of 19 atenolol patients. The following variables were measured: 24-hour ambulatory BP (Takeda TM2420), albuminuria (enzyme-linked immunosorbent assay), fractional albumin clearance, and glomerular filtration rate (GFR) ([51Cr]EDTA technique). The average reduction in mean arterial BP during the 12 months was identical in the two groups 12 +/- 2 vs. 11 +/- 1 mmHg in the lisinopril and atenolol group, respectively. Albuminuria was on average reduced 45% in the lisinopril group vs. 12% in the atenolol group (P < 0.01), and fractional albumin clearance was on average reduced 49% in the lisinopril group vs. 1% in the atenolol group (P < 0.05). GFR declined identically in the two groups 11.7 +/- 2.3 vs. 11.6 +/- 2.3 ml.min-1.year-1 in the lisinopril and atenolol groups, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Albuminuria↗
PubMed2025

Identification of Genetic Variations in HLA Region for Kidney Functions.

HLA allelic polymorphisms are associated with a variety of kidney-related traits in different populations. Although Taiwanese-specific genetic variants associated with kidney function have been reported, the role of HLA alleles is unclear. In this study, the association&#xa0;between eGFR and genetic variations in the HLA region was explored in a cohort of 59,448 Taiwanese subjects. A total of 448 genetic variations in the HLA region are significantly associated with eGFR. HLA-C*03 is associated with decreased eGFR, while HLA-DQA1*03, HLA-DQB1*03:03 and HLA-DQB1*03:03:02 demonstrated protective effects. Moreover, amino acid changes on HLA-C and HLA-DRB1 are significantly associated with eGFR. Finally, the eGFR-associated single nucleotide variations (SNVs) and insertions and deletions (indels) are enriched in the HLA-DQB1 gene. After conditional analysis, we identified two independent signals, including rs2853941, rs3830060. In summary, this study highlights the role of HLA-C, HLA-DQA1, HLA-DQB1 and HLA-DRB1 variations in kidney function in the Taiwan Han Chinese population.

Adult↗
PubMed1994

99Tcm-MAG3 renogram deconvolution in normal subjects and in normal functioning kidney grafts.

This study provides values of transit times obtained by 99Tcm- mercaptoacetyl triglycine (99Tcm-MAG3) renogram deconvolution for both normal subjects and kidney graft recipients. The analysis included 50 healthy kidney units from 25 volunteers and 28 normal functioning kidney grafts. The parameters calculated for the whole kidney (WK) and for the renal parenchyma (P) were: mean transit time (MTT) and times at 20% (T20) and 80% (T80) of renal retention function initial height. For healthy kidneys the WK MTT was 174 +/- 27 s and P MTT 148 +/- 22 s. The WK T20 values were 230 +/- 33 s and P T20 231 +/- 34 s. The WK T80 was 108 +/- 19 s and P T80 106 +/- 12 s. Whole kidney and parenchymal values of transit times for normal functioning kidney grafts do not present significant differences with respect to healthy kidneys.

Adolescent↗
PubMedDate not supplied

[Kidney function and the glucocorticoid activity of the adrenal cortex during immersion].

The paper presents the study of renal and adrenal function in six normal men during and after 3-day water immersion used as weightlessness simulation. The renal excretion of fluid, basic electrolytes, creatinine and total 17-hydroxycorticosteroids (17-HOCS) for 24 hours and following a provocative water-load test (20 ml/kg) was measured. During the first post-immersion day diuresis increased by 77%, excretion of sodium by 42%, 17-HOCS by 43% and creatinine by 34% as compared to the pre-immersion level. Potassium excretion remained essentially unchanged. The circadian rhythm of excretion of the above substances was normal: at night the excretion decreased and in the morning increased noticeably. The study of renal function and adrenal activity was carried out 56 hours after the beginning of water immersion, using a provocative water-load test. Water excretory and osmoregulatory functions of kidneys, and glucocorticoid activity of adrenals remained normal. These data give evidence that during a 60 hour exposure to water immersion no functional hypocorticism develops.

17-Hydroxycorticosteroids↗
PubMed1995

[Kidney function and electrolyte metabolism in healthy pregnant women].

In pregnant women alterations in kidney function, hormone, electrolyte and water metabolism are common findings. In 15 healthy pregnant women the kidney function and electrolyte metabolism were investigated during pregnancy and after delivery. The glomerular filtration rate measured by creatinine clearance was 20% higher in the I. trimester than in the II. and the III. trimesters and after the delivery. The sodium clearance was in the III. trimester significantly lower than in both the I. and the II. trimesters (p < 0.001, p < 0.01); the fractional sodium excretion was lowest in the third trimester. Furthermore the serum calcium concentration decreased significantly in the II. and III. trimester in comparison to the I. trimester (p < 0.01, p < 0.001), which was associated with a moderate increased urinary calcium excretion. The phosphate clearance increased during pregnancy and decreased approximately 50% after delivery (p < 0.01). The magnesium clearance was 40% higher in the third trimester in comparison to the I. trimester (p < 0.05) and 61% higher than the value post delivery (p < 0.01). The uric acid clearance during pregnancy was markedly increased and decreased 70% after delivery (p < 0.05). The results showed that in the III. trimester an intensive sodium retention occurred, which is associated with an increase of the plasma volume, interstitial fluid and body weight. The decreased serum calcium concentration in the II. and III. trimesters, the increased urinary calcium excretion as well as increased phosphate clearance suggest an increased parathyroid-hormone secretion.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1994

The effects of oral chloroquine administration on kidney function.

The effects of 3 consecutive days of oral chloroquine (1 mg/100 g body weight) on kidney function and blood pressure were studied in male Sprague-Dawley rats that were challenged with hypotonic saline infusion 24 h after the last chloroquine administration. The rats were anesthetized with Inactin [5 ethyl-5-(1'-methylpropyl)-2-thiobarbiturate, Byk Gulden] and continuously infused with 0.077 M NaCl for 8 h; urine flow and electrolyte excretion rates were monitored during the last 5 h. Blood pressure and glomerular filtration rates were also measured. Kidney function was compromised in chloroquine-treated rats, which retained significantly more of the infused Na+ and Cl- by comparison to control-vehicle-treated rats. Throughout the experimental period, chloroquine-treated rats exhibited low blood pressure (80 mm Hg vs. 127 mm Hg) which was associated with low glomerular filtration rate. The plasma aldosterone concentrations were significantly (p < 0.01) elevated in rats pretreated with chloroquine at the end of the 8-h infusion of hypotonic saline, but corticosterone levels were significantly (p < 0.01) lower in the treated rats. It is concluded that chloroquine administration impairs kidney function, resulting in inappropriate Na+ and Cl- retention. This effect is likely to be mediated via chloroquine-induced increases in plasma aldosterone concentration and lowering of GFR.

Administration, Oral↗
PubMed1992

Quantitative renal scintigraphic determination of the glomerular filtration rate in cats with normal and abnormal kidney function, using 99mTc-diethylenetriaminepentaacetic acid.

The nuclear imaging technique known as quantitative renal scintigraphy was validated as a means to assess the kidney function of cats. Renal function tests were performed in 6 healthy cats and 3 cats with clinical manifestations of kidney failure. In addition, the nephrotoxic drugs, gentamicin sulfate, or amphotericin B were used in an attempt to induce renal failure in 4 cats. Using linear regression analysis, equations were derived to estimate the glomerular filtration rate (GFR) on the basis of the renal percent uptake of 99mTc-diethylenetriaminepentaacetic acid (99mTc-DTPA). One-way ANOVA and Student's t test were used to evaluate treatment effects on clearances of inulin and creatinine, percent uptake of 99mTc-DTPA, and serum creatinine concentrations. The results show that the percent uptake of 99mTc-DTPA by the kidneys correlated well with the GFR obtained through the clearance of inulin. Thus, it was concluded that quantitative renal scintigraphy, using 99mTc-DTPA as a marker of kidney function, is an adequate technique to estimate the kidney function of healthy cats and cats with functional renal impairment. The best estimate of the GFR of cats, using the percentage dose of 99mTc-DTPA, was obtained on the 1- to 3-minute postinjection interval of the marker, using data that was background-subtracted, but not corrected for tissue absorption of gamma rays or binding of 99mTc-DTPA to plasma proteins. There was no significant difference in the mean inulin clearance, creatinine clearance, or percent uptake of 99mTc-DTPA between the 3 treatment groups of this study.(ABSTRACT TRUNCATED AT 250 WORDS)

Acute Kidney Injury↗
PubMed2026

The interplay between impaired kidney function and hypertension in dementia: A 13-year longitudinal study.

BackgroundHypertension and kidney function impairment (KFI) are established risk factors for dementia and may reinforce each other. However, whether their coexistence confers excess dementia risk remains unclear.ObjectiveTo examine the multiplicative and additive interactions between hypertension and KFI in relation to incident dementia and explore potential biological pathways.MethodsWe included 218,858 dementia-free adults followed for a mean of 13.2 years. KFI was defined as an estimated glomerular filtration rate <60&#x2005;mL/min/1.73&#x2005;m2. Cox proportional hazards models assessed independent associations and multiplicative interaction, while additive interaction was evaluated using the relative excess risk due to interaction (RERI), attributable proportion (AP), and synergy index (SI). Plasma proteomic data on 2911 proteins were available for 6127 participants.ResultsHypertension was associated with dementia risk (hazard ratio [HR], 1.24; 95% confidence interval [CI], 1.17-1.31; p&#x2009;<&#x2009;0.001), whereas KFI was not (HR, 1.02; 95% CI, 0.94-1.11; p&#x2009;=&#x2009;0.571). A significant multiplicative interaction was observed (p&#x2009;=&#x2009;0.018). KFI was associated with dementia only among participants with hypertension (HR, 1.15; 95% CI, 1.01-1.29; p&#x2009;=&#x2009;0.023). A positive additive interaction was also observed (RERI, 0.27; 95% CI, 0.05-0.49; AP, 0.17; 95% CI, 0.05-0.29; SI, 1.84; 95% CI, 1.11-3.07), although it was attenuated after full adjustment. Proteomic analyses implicated immune and inflammatory pathways.ConclusionsHypertension may modify the association between impaired kidney function and dementia risk. Their coexistence may identify individuals at higher risk, but further studies are needed to confirm these findings and clarify the underlying mechanisms.

Humans↗
PubMed1993

[Percutaneous transluminal angioplasty in the treatment of stenosis of the renal artery in solitary functioning kidney].

The authors report 2 cases of patients with single functioning kidney and severe hypertension caused by renal artery stenosis who were treated by percutaneous transluminal angioplasty (PTA). In one case an early and persistent improvement of renal function and a reduction of pressure values were observed. In the other patient, with preexistent severe functional damage, a progressive impairment of renal function required haemodialysis. On the basis of these results and of other reports in the literature, PTA is proposed as elective treatment of renal artery stenosis in patients with single functioning kidney.

Angioplasty, Balloon↗
PubMed1981

Renal excretion of sulphamethoxazole and its metabolite N4-acetylsulphamethoxazole in patients with impaired kidney function.

Plasma and urine concentrations of creatinine, sulphamethoxazole and its metabolite N4-acetylsulphamethoxazole were measured in patients with varying degrees of kidney impairment. The plasma elimination half-life of sulphamethoxazole is not influenced by the kidney function, while the half-life of the metabolite is fully dependent on the kidney function. The renal clearances of the metabolites and that of the parent compound under alkaline urine conditions are linearly related to the creatinine clearance. Kidney impairment affects only the renal clearance of the metabolite, whereas sulphamethoxazole is metabolized (acetylated) independently of kidney function.

Acetylation↗
PubMed1987

Effect of saline adaptation and renal portal sodium infusion on glomerular size distributions and kidney function in domestic fowl.

Experiments were designed to evaluate acute and chronic effects of sodium on glomerular size distributions and kidney function of Single Comb White Leghorns. Chicks were raised on either tap water (control) or .6% NaCl (saline) drinking water. Kidney function studies were conducted when the birds reached 14 to 16 weeks of age. Saline-adapted birds had significantly lower glomerular filtration rates and significantly higher sodium and potassium excretion rates when compared with birds raised on tap water. Acute effects of sodium on kidney function were assessed by infusing 25 mM tetrasodium pyrophosphate unilaterally into the renal portal system. For birds raised on tap water, unilateral sodium infusion caused a significant unilateral reduction in the glomerular filtration rate. However, neither the acute nor the chronic reductions in glomerular filtration rates in response to sodium were associated with a reduction in the number of filtering nephrons. Saline-adapted birds had significantly hypertrophied glomeruli.

Animals↗
PubMed1989

Phosphorus-induced nephrocalcinosis and kidney function in female rats.

The question was addressed whether dietary phosphorus-induced nephrocalcinosis in rats is associated with impaired kidney function. Weanling female rats were fed purified diets containing either 0.4 or 0.6% (wt/wt) phosphorus for 28 d. The diet containing 0.6% phosphorus produced marked kidney calcification, as determined both by chemical analysis of kidney calcium and histological examination in kidney sections. Histological examination did not show calcification in stomach, lung, heart or thoracic aorta, which are predisposition sites of metastatic calcification in secondary renal hyperparathyroidism. In rats fed the 0.6% phosphorus diet, phosphorus retention and urinary excretion were greater compared with rats fed the 0.4% phosphorus diet. The following indicators of kidney function were examined: water intake, urinary volume, urine and plasma osmolality, urine and plasma creatinine, urine and plasma urea, urea and creatinine clearance and urinary albumin excretion. Of these indicators, only urinary albumin excretion was significantly increased in rats fed the nephrocalcinogenic diet. In a further experiment, the increase of urinary albumin was reproduced. After pooling the results of the two experiments, in individual rats fed the 0.6% phosphorus diet, the concentration of kidney calcium was found to be positively related with kidney weight expressed relative to body weight (r = 0.82, n = 22) and with albumin excretion in urine (r = 0.79, n = 28). The increased weight of calcinotic kidneys was mainly due to both calcium deposition and tubular hyperplasia. It is concluded that dietary phosphorus-induced nephrocalcinosis is associated with impaired kidney function in rats.

Albumins↗
PubMedDate not supplied

Kidney function in heart-lung transplant recipients: the effect of low-dosage cyclosporine therapy.

The indices of kidney function of all discharged heart-lung transplant survivors were examined before and after the introduction of a triple-drug immunosuppressive regimen comprised of low dosages of cyclosporine (to maintain a trough serum level of 75 to 100 ng/ml by radioimmunoassay), azathioprine (1 to 1.5 mg/kg/day), and prednisone. A comparison of survivors treated with either high dosages of cyclosporine (n = 19) or low dosages of cyclosporine (n = 8) revealed a lower early creatinine level postoperatively (1.84 versus 0.96 mg/dl), a higher creatinine clearance (46.33 versus 62.47 ml/min), and a lower cyclosporine level (337.96 versus 204.30 ng/ml) in the latter group. The findings from the outpatient period were similar to the above, and all findings were statistically significant (p less than or equal to 0.05). Another comparison of a subgroup of survivors (n = 11) before and after conversion to the low dosage cyclosporine triple-drug regimen demonstrated no significant difference in kidney function for nine patients and equivocal evidence of improvement in the other two patients for creatinine levels and creatinine clearance. Overall, despite the lower cyclosporine dosage used, we have not encountered an increased prevalence of acute heart or lung rejection. We conclude that early implementation of low dosages of cyclosporine, as part of a triple-drug immunosuppression regimen, is associated with preservation of kidney function while maintaining adequate immunosuppression. Patients with chronic azotemia from long-term cyclosporine therapy may still reap some benefit from this regimen.

Creatinine↗
PubMed1991

Effect of arginine depletion on glomerular and tubular kidney function: studies in isolated perfused rat kidneys.

The effect of L-Arg depletion on glomerular hemodynamics and tubular function of isolated rat kidneys perfused with a medium containing 21 amino acids has been studied. A cyclooxygenase inhibitor was added throughout for blockade of prostaglandin synthesis. Arg depletion caused significant (approximately 30%) reductions in renal perfusion flow rate (PFR, 13.9 +/- 1.2 vs. 19.8 +/- 0.6 ml.min-1.g (kidney wt-1), glomerular filtration rate (GFR, 598 +/- 79 vs. 924 +/- 42 microliters.min-1.g kidney wt-1), and urine flow rate (139 +/- 38 vs. 192 +/- 13 microliters.min-1.g kidney wt-1) compared with control kidneys, which were perfused with a physiological concentration of Arg (200 microM). Filtration fraction (FF) increased with Arg depletion (5.1 +/- 0.4 vs. 4.4 +/- 0.4%). Arg-depleted kidneys had a lower absolute sodium (TNa, 75.7 +/- 8.8 vs. 107.9 +/- 6.0 mumol.min-1.g kidney wt-1) and glucose reabsorption (T glucose, 3.7 +/- 0.6 vs. 5.6 +/- 0.5 mumol.min-1.g kidney wt-1), corresponding to a lower sodium and glucose filtration. Potassium handling and reabsorption of free water were not changed. Oxygen consumption (QO2) was lower in Arg-depleted kidneys (4.6 +/- 0.3 vs. 5.5 +/- 0.5 mumol.min-1.g kidney wt-1). The effects of Arg depletion were completely reversed by the addition of Arg (1 mM) at 120 min and partly reversed by the addition of citrulline (1 mM). Ornithine depletion or addition had no effect on PFR, GFR, FF, TNa, T glucose, and QO2. N omega-methyl-L-arginine, a specific inhibitor of nitric oxide endothelium-derived relaxing factor, produced the same effect as Arg depletion.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗