==================================HSR44==================================
44. Laboratory tests for end-stage renal disease patients.
1
UI - 87097464
AU - Beaufils M ; Lantz B ; Paillard F ; Richet G
TI - Effects of tertatolol in hypertensive patients with chronic renal
failure.
AB - Chronic renal failure (CRF) is often associated with hypertension, as a
cause or a consequence. We studied the changes in blood pressure (BP),
heart rate (HR), renal function (as measured by creatinine clearance),
and plasma renin activity (PRA) in 19 hypertensive patients with CRF
before, during and after oral administration once a day for at least 30
days of 5 mg tertatolol, a new beta-blocker. All patients were free of
any antihypertensive medication for at least 1 month before
administration of tertatolol. The dose of tertatolol given in this study
was the same as that commonly used in patients with normal renal
function. From day 0 to day 30 of tertatolol, measurements in the supine
position were as follows: systolic BP (SBP) decreased from 168.4 +/- 4.6
to 145.3 +/- 4.3 mm Hg (p less than 0.01); diastolic BP (DBP) decreased
from 106.1 +/- 2.4 to 87.1 +/- 2.0 mm Hg (p less than 0.01); HR decreased
from 77.9 +/- 1.6 to 63.2 +/- 1.7 b.p.m. (p less than 0.01); PRA
decreased from 1.816 +/- 0.521 to 1.052 +/- 0.323 ng/ml/h (p less than
0.01). Creatinine clearance remained stable: 37.1 +/- 4.1 versus 37.1 +/-
4.7 ml/min/1.73 m2 (not significant). Similar results (for SBP, DBP, HR
and PRA) were obtained in the erect position. It is concluded that
tertatolol in hypertensive patients with CRF: significantly lowers BP and
HR without excessive bradycardia, significantly lowers PRA, the most
important decrease being observed for the highest initial PRA, does not
alter renal function, and has a good clinical acceptability.
MH - Adrenergic Beta Receptor Blockaders/*PHARMACODYNAMICS ; Adult ; Female ;
Glomerular Filtration Rate/DRUG EFFECTS ; Human ; Hypertension/*DRUG
THERAPY/PHYSIOPATHOLOGY ; Kidney Failure, Chronic/*PHYSIOPATHOLOGY ; Male
; Middle Age ; Propanolamines/*PHARMACODYNAMICS/THERAPEUTIC USE ; Renal
Circulation/DRUG EFFECTS ; Renin/BLOOD
SO - Am J Nephrol 1986;6 Suppl 2:50-4
2
UI - 87074421
AU - Nesbitt JC ; McDougal WS ; Lowe W ; Abumrad NN ; Nylander WA
TI - A new model to study acute and chronic renal failure.
AB - Many models have been developed to study renal function following injury.
Two types of studies have evolved: acute--to define the acute renal
injury and chronic--to determine the pattern of recovery. Current models
allow either study alone to be performed, but they lack the flexibility
to combine the studies. In this study of renal ischemia, a model was
designed which solved this problem. The authors constructed a model for
performing a unilateral nephrectomy and episiotomy on female dogs.
Catheters were placed in the renal vein, vena cava, and aorta, and a
renal artery flow cuff was applied. The catheters and wires were buried
in a subcutaneous pocket and were exteriorized after a recovery of
several weeks. The episiotomy allowed easy intermittent Foley
catheterization. With the animals awake and in a harness, parameters of
renal function were measured: renal extraction, filtration fraction,
fractional excretion, osmolar clearance, and free water clearance.
Glomerular filtration rate and renal plasma flow were calculated by
inulin and paramino hippurate clearances. The animals were studied in
diuretic and antidiuretic states. In addition, renal artery flow was
determined by the Doppler flow cuff. All parameters were determined every
half hour in the acute setting, then every day in the chronic setting.
The model was easily reproducible and functioned well in the authors'
renal ischemia studies. Initial experiments with 1 hour of warm ischemia
produced a greater than 50 per cent reduction in GFR acutely. Chronic
studies showed a GFR with a return toward normal. All model construction
purposes and plans were met.(ABSTRACT TRUNCATED AT 250 WORDS)
MH - Animal ; Disease Models, Animal ; Dogs ; Female ; Kidney Failure, Acute/
*ETIOLOGY ; Kidney Failure, Chronic/*ETIOLOGY ; Kidney Function Tests ;
Renal Artery Obstruction/ETIOLOGY ; Renal Circulation
SO - Am Surg 1986 Dec;52(12):651-3
3
UI - 87073429
AU - Brater DC ; Anderson SA ; Brown-Cartwright D ; Toto RD
TI - Effects of nonsteroidal antiinflammatory drugs on renal function in
patients with renal insufficiency and in cirrhotics.
AB - We have assessed the effects of acute and chronic administration of
etodolac, ketoprofen, and indomethacin on renal function in patients with
mild to moderate chronic renal insufficiency (CRI). We studied 18 normal
volunteers and 24 patients with CRI due to hypertension and/or diabetes
mellitus with creatinine clearances between 19 and 83 mL/min/1.73 m2.
Clearance studies were performed with the first dose of nonsteroidal
antiinflammatory drug (NSAID) to compare acute effects of the agent with
a no-drug control. Subjects then received the NSAID for three to five
days and, on the last day of study, underwent another clearance study to
assess the effects of a single dose of NSAID superimposed on chronic
dosing. With each dose of each NSAID, inulin and paraaminohippurate (PAH)
clearances and fractional excretion of NA+ decreased. However, the
baseline control collections after chronic dosing did not differ from the
no-drug control periods. Hence, the decline in renal function with each
dose is transient, and no overall adverse effect on renal function
occurred with chronic dosing. In five patients with cirrhosis, we
assessed the renal sparing effects of sulindac. After equilibration on a
fixed sodium intake, they received a 200-mg dose of sulindac. In one
patient, no adverse effect occurred; the remaining patients suffered
declines in creatinine clearance of 29%, 87%, 37%, and 37%, respectively.
This effect was transient and returned to control values six to eight
hours after sulindac administration. At the time of maximal depression of
renal function, serum concentrations of sulindac sulfide were comparable
to those in subjects with normal hepatic function.(ABSTRACT TRUNCATED AT
250 WORDS)
MH - Acetic Acids/PHARMACODYNAMICS ; Anti-Inflammatory Agents, Non-Steroidal/
ADMINISTRATION & DOSAGE/ADVERSE EFFECTS/*PHARMACODYNAMICS ; Creatinine/
URINE ; Human ; Indomethacin/PHARMACODYNAMICS ; Ketoprofen/
PHARMACODYNAMICS ; Kidney Failure, Chronic/*PHYSIOPATHOLOGY ; Kidney
Function Tests ; Kidney/*DRUG EFFECTS/PHYSIOPATHOLOGY ; Liver Cirrhosis,
Alcoholic/*PHYSIOPATHOLOGY ; Prostaglandins E/URINE ; Sulindac/
PHARMACODYNAMICS ; Support, Non-U.S. Gov't ; Support, U.S. Gov't, P.H.S.
SO - Am J Kidney Dis 1986 Nov;8(5):351-5
4
UI - 87073421
AU - Verpooten GA ; Giuliano RA ; Pattyn VM ; Scharp:e SL ; De Broe ME
TI - Renal cortical uptake kinetics of gentamicin in rats with impaired renal
function.
AB - The renal cortical uptake kinetics of the aminoglycoside antibiotic
gentamicin was determined in the remnant kidney model. Renal failure was
induced by partial ablation of the right kidney followed by left
nephrectomy in female Wistar rats. The animals received a six-hour
gentamicin infusion at a constant rate yielding steady-state serum
concentrations ranging from 0.5 to 150 micrograms/mL. The renal cortical
gentamicin concentrations were determined and related to the serum
concentrations achieved. This relationship was nonlinear and followed
Michaelis-Menten kinetics. Gentamicin cortical uptake rate, however, did
not show clear saturation in the range of gentamicin serum levels studied
as was observed in rats with normal renal function. The Michaelis-Menten
parameters determined by nonlinear regression were Km = 15.0, 73.9, and
135.7 micrograms/mL; and Vmax = 149.9, 213.7, and 239.2 micrograms/g
cortex/h, respectively, for controls, rats with serum creatinine levels
between 0.9 and 1.2 mg/dL, and those with levels between 1.3 and 1.8
mg/dL. It is concluded that at serum levels below 100 micrograms/mL, the
gentamicin renal cortical uptake is diminished in rats with renal
failure. This decrease in renal cortical uptake is more pronounced in the
group of rats with more severe renal failure.
MH - Animal ; Creatinine/METABOLISM ; Female ; Gentamicins/*METABOLISM ;
Glomerular Filtration Rate ; Kidney Cortex/*METABOLISM ; Kidney Failure,
Chronic/*METABOLISM/PHYSIOPATHOLOGY ; Kinetics ; Rats ; Rats, Inbred
Strains ; Support, Non-U.S. Gov't
SO - Am J Kidney Dis 1986 Nov;8(5):304-7
5
UI - 87065313
AU - Fr:ohling PT ; Birnbaum M ; Halle H ; Lindenau K
TI - Successful pregnancy of a woman with advanced renal failure on
nutritional treatment.
AB - A case is reported of a successful pregnancy of a woman with advanced
renal failure treated nutritionally. The importance of an intensive
interdisciplinary medical co-working is stressed, and the individual
adaptation of the dietary treatment to the special nutritional
requirements in pregnancy is discussed.
MH - Adult ; Case Report ; Female ; Follow-Up Studies ; Glomerular Filtration
Rate ; Human ; Infant, Newborn ; Kidney Failure, Chronic/*COMPLICATIONS/
DIET THERAPY ; *Nutrition ; Pregnancy Complications/*DIET THERAPY ;
Pregnancy ; Pyelonephritis/COMPLICATIONS
SO - Nephron 1986;44(3):195-7
6
UI - 87062081
AU - Toto RD ; Anderson SA ; Brown-Cartwright D ; Kokko JP ; Brater DC
TI - Effects of acute and chronic dosing of NSAIDs in patients with renal
insufficiency.
AB - Administration of nonsteroidal anti-inflammatory drugs (NSAIDs) to
patients with chronically impaired renal function has been reported to
cause abrupt and sustained reductions in renal plasma flow (RPF),
glomerular filtration rate (GFR), and solute and water excretion in
association with decreased renal prostanoid production. However, the time
course of these acute effects and whether they are sustained during
chronic exposure to the NSAIDs are unknown. Accordingly, using standard
clearance and balance techniques, we investigated the effects of acute
(zero to four hours) and chronic (five days) oral administration of two
different NSAIDs on renal function in patients with stable, mild to
moderate chronic renal insufficiency (CRI) and in normal subjects. In
patients, acute oral administration of ketoprofen (K) and indomethacin
(I) resulted in significant decreases in GFR (K: from 36 +/- 3 to 20 +/-
4 ml/min, P = 0.001; I: from 37 +/- 6 to 30 +/- 7 ml/min, P = 0.032; in
RPF (K: from 194 +/- 21 to 146 +/- 21 ml/min, P = 0.002; I: from 222 +/-
33 to 147 +/- 18 ml/min, P = 0.016); and in urinary PGE2 excretion (K:
from 0.60 +/- 0.25 to 0.08 +/- 0.02 ng/min, P = 0.05; I: from 0.34 +/-
0.06 to 0.18 +/- 0.06 ng/min, P = 0.042). Fractional excretion of sodium
chloride and fractional free water clearance (CH2O/CIn) also decreased
significantly after both agents. In normal subjects, GFR and RPF were not
significantly decreased after acute dosing, whereas urinary PGE2 and
fractional excretions of NaCl and free water decreased
significantly.(ABSTRACT TRUNCATED AT 250 WORDS)
MH - Adult ; Aged ; Aged, 80 and over ; Anti-Inflammatory Agents,
Non-Steroidal/ADMINISTRATION & DOSAGE/*ADVERSE EFFECTS ; Female ;
Glomerular Filtration Rate/DRUG EFFECTS ; Hemodynamics/DRUG EFFECTS ;
Human ; Indomethacin/ADMINISTRATION & DOSAGE/ADVERSE EFFECTS ; Ketoprofen/
ADMINISTRATION & DOSAGE/ADVERSE EFFECTS ; Kidney Failure, Chronic/*DRUG
THERAPY/PHYSIOPATHOLOGY ; Kidney/*DRUG EFFECTS/PHYSIOPATHOLOGY ; Male ;
Middle Age ; Renal Circulation/DRUG EFFECTS ; Support, Non-U.S. Gov't ;
Support, U.S. Gov't, P.H.S.
SO - Kidney Int 1986 Nov;30(5):760-8
7
UI - 87054185
AU - van Kalken CK ; van der Meulen J ; Oe PL ; Vriesendorp R ; Donker AJ
TI - Pharmacokinetics of trimazosin and its effects on blood pressure, renal
function and proteinuria during short-term therapy of patients with
impaired renal function and hypertension.
AB - The kinetics and short-term (10 weeks) effects of trimazosin, an alpha
1-adrenoreceptor antagonist, on renal function and blood pressure in
patients with moderate chronic renal insufficiency and hypertension, have
been studied for the first time. Eight patients in whom the blood
pressure was not normalized with a diuretic alone underwent
pharmacokinetic studies and assessment of the renal function during a
10-week period of trimazosin therapy. Trimazosin significantly lowered
blood pressure (recumbent and upright) without significantly altering
renal function. Renal vascular resistance was decreased by 14%.
Fractional sodium excretion, proteinuria and laboratory serum tests
remained unchanged. Neither body weight nor pulse rate were affected.
Moderate renal insufficiency did not modify the pharmacokinetics of the
drug. Thus, trimazosin, as second-step antihypertensive agent, appeared
to be safe and effective in patients with moderate renal insufficiency
and hypertension, without exerting favourable or adverse renal effects
during short-term therapy.
MH - Adult ; Aged ; Antihypertensive Agents/METABOLISM/*THERAPEUTIC USE ;
Blood Pressure/DRUG EFFECTS ; Female ; Glomerular Filtration Rate/DRUG
EFFECTS ; Human ; Hypertension, Renal/*DRUG THERAPY/ETIOLOGY ; Iodine
Radioisotopes/DIAGNOSTIC USE ; Kidney Failure, Chronic/*COMPLICATIONS ;
Kidney/DRUG EFFECTS ; Kinetics ; Male ; Middle Age ; Piperazines/
METABOLISM/*THERAPEUTIC USE ; Proteinuria/*DRUG THERAPY ; Renal
Circulation/DRUG EFFECTS
SO - Eur J Clin Pharmacol 1986;31(1):63-8
8
UI - 87035903
AU - Wolfson M ; Laidlaw SA ; Flugel-Link RM ; Strong CJ ; Salusky IB ; Kopple
JD
TI - Effect of vitamin B-6 deficiency on plasma amino acid levels in
chronically azotemic rats.
AB - Chronic renal failure is associated with many abnormalities in plasma
amino acids. Since patients with renal failure are frequently deficient
in vitamin B-6, this study examined whether vitamin B-6 deficiency may be
a cause of any of the abnormal plasma amino acid concentrations observed
in chronic renal failure. Sham-operated and chronically azotemic rats
were pair-fed diets deficient in or replete with vitamin B-6 for 21 d. By
the end of 21 d, the EGOT index rose significantly in the B-6-deficient
rats but not in the B-6-replete animals. There were several differences
in plasma amino acid concentrations between azotemic and control rats.
Azotemia and B-6 deficiency each lowered the plasma serine concentration
and raised the glycine-to-serine ratio. Plasma glycine was affected by a
two-way interaction between azotemia and vitamin B-6 deficiency whereby
the highest values were found in the sham-operated vitamin B-6-deficient
animals. Plasma alanine and asparagine were reduced by B-6 deficiency and
unchanged by azotemia. These results suggest that vitamin B-6 deficiency
may contribute to several of the abnormalities in the plasma aminograms
observed in chronic renal failure.
MH - Amino Acids/*BLOOD ; Animal ; Body Weight ; Kidney Failure, Chronic/
*BLOOD/COMPLICATIONS ; Kidney Function Tests ; Male ; Rats ; Rats, Inbred
Strains ; Vitamin B Deficiency/*BLOOD/COMPLICATIONS
SO - J Nutr 1986 Oct;116(10):1865-72
9
UI - 87034298
AU - Nath KA ; Kren SM ; Hostetter TH
TI - Dietary protein restriction in established renal injury in the rat.
Selective role of glomerular capillary pressure in progressive glomerular
dysfunction.
AB - Dietary protein restriction imposed before renal injury is established in
the remnant kidney model in the rat reduces glomerular hypertension and
hyperperfusion and renal injury. We demonstrate that dietary protein
restriction (6% vs. 20%) imposed on a background of established renal
injury in the remnant model leads to a greater preservation of renal
function as measured by glomerular filtration rate and fractional
clearances of albumin and IgG, despite the persistence of systemic
hypertension. In similarly prepared rats, dietary protein restriction (6%
vs. 20%) led to a lower glomerular capillary hydraulic pressure, a higher
ultrafiltration coefficient, and similar single nephron filtration rates.
In addition, less impairment of glomerular permselectivity was
demonstrable after protein restriction. Our data demonstrate that the
preservation of renal function with dietary protein restriction after
established glomerular injury follows upon reduction of glomerular
capillary hydraulic pressure, despite constancy of single nephron
filtration rate and plasma flow and persistence of arterial hypertension.
MH - Animal ; Blood Pressure ; *Dietary Proteins ; Disease Models, Animal ;
Glomerular Filtration Rate ; Hypertension, Renal/PREVENTION & CONTROL ;
Kidney Failure, Chronic/*DIET THERAPY/PHYSIOPATHOLOGY ; Kidney Glomerulus/
BLOOD SUPPLY/*PHYSIOPATHOLOGY ; Male ; Rats ; Rats, Inbred Strains ;
Regional Blood Flow ; Renal Circulation ; Support, Non-U.S. Gov't ;
Support, U.S. Gov't, P.H.S.
SO - J Clin Invest 1986 Nov;78(5):1199-205
10
UI - 87026450
AU - van der Meulen J ; Reijn E ; Heidendal GA ; Oe PL ; Donker AJ
TI - Comparison of the effects of penbutolol and propranolol on glomerular
filtration rate in hypertensive patients with impaired renal function.
AB - Penbutolol and propranolol were administered orally in a dosage of 40 mg
once daily and 80 mg twice daily, respectively to 12 patients with
hypertension and impaired renal function. Both drugs caused a significant
decrease in mean arterial pressure and heart rate. Serum creatinine
concentration increased significantly by 10% during therapy with
propranolol without concomitant decrease in creatinine clearance. No such
effect was seen with penbutolol. GFR measured with [125I]-iothalamate
showed no significant changes with both drugs.
MH - Blood Pressure/DRUG EFFECTS ; Clinical Trials ; Comparative Study ;
Creatinine/BLOOD/METABOLISM ; Double-Blind Method ; Glomerular Filtration
Rate/*DRUG EFFECTS ; Human ; Hypertension/*COMPLICATIONS/DRUG THERAPY ;
Kidney Failure, Chronic/*COMPLICATIONS ; Penbutolol/*PHARMACODYNAMICS/
THERAPEUTIC USE ; Propanolamines/*PHARMACODYNAMICS ; Propranolol/
*PHARMACODYNAMICS/THERAPEUTIC USE ; Random Allocation
SO - Br J Clin Pharmacol 1986 Oct;22(4):469-74
11
UI - 87026113
AU - Lewandowski A ; Kozaczek W ; Orlowski T ; Weuta H
TI - Kidney function of pyelonephritis patients with impaired renal function
treated with mezlocillin.
AB - Ten patients with pyelonephritis and impaired renal function were treated
with 2.0 g mezlocillin (Baypen) 8-hourly. They all recovered from urinary
tract infection and showed a distinct improvement of their kidney
function measured by blood urea nitrogen, serum creatinine and creatinine
clearance. No side effects were seen and the blood coagulation remained
within normal limits. An overview of the literature on urinary tract
infections treated in patients with impaired kidney function is given.
MH - Adult ; Aged ; Female ; Human ; Kidney Failure, Chronic/*COMPLICATIONS/
PHYSIOPATHOLOGY ; Kidney Function Tests ; Male ; Mezlocillin/*THERAPEUTIC
USE ; Middle Age ; Pyelonephritis/COMPLICATIONS/*DRUG THERAPY/
PHYSIOPATHOLOGY ; Urinary Tract Infections/COMPLICATIONS/*DRUG THERAPY/
PHYSIOPATHOLOGY
SO - Arzneimittelforschung 1986 Jul;36(7):1148-50
12
UI - 86311508
AU - Adler AJ ; Berlyne GM
TI - Silicon metabolism. II. Renal handling in chronic renal failure patients.
AB - In 36 patients suffering from chronic renal failure (mean creatinine
clearance 26 ml/min), serum silicon levels were significantly increased
(mean 0.52 microgram/ml compared with 0.265 microgram/ml in normals; p
less than 0.005). Urinary silicon excretion per 24 h was significantly
decreased (15.71 mg/24 h compared with 21.4 mg/24 h in normals; p less
than 0.001). Fractional excretion of silicon (FESi) was significantly
increased in chronic renal failure (p less than 0.001), with overall
tubular secretion of silicon in 33% of patients. Urinary excretion of
silicon was significantly related to urinary calcium excretion (p less
than 0.0001) urinary magnesium excretion (p less than 0.0001) creatinine
clearance (p less than 0.05) and sodium excretion (p less than 0.05). It
is suggested that urinary silicon is in the form of orthosilicate,
principally bound to calcium and magnesium; and that in chronic renal
failure the increase in FESi, and the decrease in absorbed Si from the
gastrointestinal tract, moderate the increase in plasma silicon levels
and prevent excessive entry of silicon into the tissues.
MH - Adult ; Aged ; Comparative Study ; Glomerular Filtration Rate ; Human ;
Kidney/*METABOLISM ; Kidney Failure, Chronic/*METABOLISM ; Male ; Middle
Age ; Reference Values ; Silicon/BLOOD/*METABOLISM/URINE
SO - Nephron 1986;44(1):36-9
13
UI - 86295149
AU - Teschan PE
TI - Clinical estimates of treatment adequacy.
AB - Adequacy of rapid, high-efficiency therapies (RHET) in patients with
end-stage renal failure involves comparisons with hemodialysis, the
primary reference standard. However, the latter's adequacy is also
insecurely rendered in descriptive, subjective terms that often embrace
outcomes beyond legitimate expectations of the dialysis process. Many
measurable abnormalities in renal failure contribute little to patients'
clinical illness and respond poorly to dialysis. It is therefore proposed
that adequacy for all proposed clinical treatment modalities, including
RHET, be based on objective, quantitative measures of what such
treatments actually do: control volume and dialyzable solute composition
of the body fluids, and suppress the uremic illness. Recognition of the
dialysis-responsive--and also disabling--uremic illness as an
encephalopathic, neurobehavioral (NB) disorder logically led to objective
documentation of quantitative NB impairments that varied inversely with
the amount of hemodialysis and improved following renal transplantation.
Similar objective documentations of RHET are needed.
MH - Blood Urea Nitrogen ; Dietary Proteins/METABOLISM ;
Electroencephalography ; Hemodialysis ; Human ; Kidney Failure, Chronic/
*THERAPY ; Male ; Time Factors ; Ultrafiltration
SO - Artif Organs 1986 Jun;10(3):201-4
14
UI - 86292945
AU - Feinfeld DA ; Briscoe AM ; Nurse HM ; Hotchkiss JL ; Thomson GE
TI - Myoglobinuria in chronic renal failure.
AB - Serum and urine myoglobin levels were determined on 14 patients with
stable chronic renal failure. Serum myoglobin ranged from 38 to 350
ng/mL. Eleven patients had myoglobinuria between 15 and 250 ng/mL; none
developed myoglobinuric renal failure. Fractional excretion of myoglobin
in the myoglobinuric patients increased as creatinine clearance
decreased, although there was no correlation between filtered load and
excretion rate of myoglobin. This confirms that renal failure leads to
hypermyoglobinemia and usually to myoglobinuria. Surviving nephrons tend
to reabsorb less of the filtered load of myoglobin as renal function
diminishes.
MH - Glomerular Filtration Rate ; Human ; Kidney Failure, Chronic/BLOOD/
*COMPLICATIONS/PHYSIOPATHOLOGY/URINE ; Myoglobin/BLOOD ; Myoglobinuria/
BLOOD/*ETIOLOGY/PHYSIOPATHOLOGY ; Rhabdomyolysis/*ETIOLOGY
SO - Am J Kidney Dis 1986 Aug;8(2):111-4
15
UI - 86292284
AU - Christensen S ; Ottosen PD
TI - Lithium-induced uraemia in rats: survival and renal function and
morphology after one year.
AB - Chronic renal failure was induced in Wistar rats by administration of a
LiCl-containing (40 mmol/kg) diet from birth until an age of 55-65 weeks.
The 55 weeks mortality was 51% in Li-uraemic rats versus 6% in control
rats. In surviving rats the mean plasma Li levels were 0.6-0.7 mmol/l
after 16 weeks and 1.0-1.1 mmol/l after 48 weeks. The mean plasma urea
level was 14 mmol/l after 16 weeks and 22 mmol/l after 48 weeks of
treatment compared with 8 mmol/l in the controls rats. In 55 weeks old
Li-uraemic rats inulin clearance was reduced by 62% and Li clearance by
39%. Thus, fractional Li excretion was increased (from 20 to 34%) in rats
with chronic Li-uraemia. Li-uraemic rats also had polyuria and failed to
concentrate their urine in response to exogenous vasopressin. Systolic
and mean arterial blood pressures were not significantly changed in rats
with Li-uraemia. Morphological examinations of the kidneys showed large
cortical cysts formed by dilated distal tubules and collecting ducts and
widespread interstitial fibrosis. Proximal tubular mass was reduced by
50% and glomerular volume was also significantly reduced. The results
indicate that in rats with Li-induced uraemia renal function and
morphology deteriorate during Li-exposure up to an age of one year,
associated with increased mortality.
MH - Animal ; Blood Pressure/DRUG EFFECTS ; Glomerular Filtration Rate/DRUG
EFFECTS ; Kidney/PATHOLOGY/*PHYSIOPATHOLOGY ; Kidney Concentrating
Ability/DRUG EFFECTS ; Kidney Failure, Chronic/*CHEMICALLY INDUCED/
PHYSIOPATHOLOGY ; Lithium/BLOOD/*TOXICITY ; Rats ; Rats, Inbred Strains ;
Sodium/METABOLISM ; Uremia/*CHEMICALLY INDUCED/PHYSIOPATHOLOGY
SO - Acta Pharmacol Toxicol (Copenh) 1986 May;58(5):339-47
16
UI - 86268170
AU - Rubin J ; Ball R
TI - Continuous ambulatory peritoneal dialysis as treatment of severe
congestive heart failure in the face of chronic renal failure. Report of
eight cases.
AB - Eight patients with severe heart failure and renal insufficiency whose
conditions were refractory to diuretics were treated by continuous
ambulatory peritoneal dialysis. Seven of the eight patients died.
Although the patients no longer had uncontrolled congestive heart
failure, hospitalization rates failed to improve due to dialysis
complications and underlying heart disease. The one long-term survivor
was being treated with diuretics alone after peritoneal dialysis was used
to control heart failure. Although survival was short after initiation of
dialysis (median survival, 225 days), this therapy may merit further
study in patients less ill.
MH - Aged ; Body Weight ; Female ; Heart Failure, Congestive/COMPLICATIONS/
MORTALITY/PHYSIOPATHOLOGY/*THERAPY ; Human ; Kidney Failure, Chronic/
*COMPLICATIONS/PHYSIOPATHOLOGY ; Kidney Function Tests ; Male ; Middle
Age ; *Peritoneal Dialysis, Continuous Ambulatory
SO - Arch Intern Med 1986 Aug;146(8):1533-5
17
UI - 86255150
AU - Lucas PA ; Meadows JH ; Roberts DE ; Coles GA
TI - The risks and benefits of a low protein-essential amino acid-keto acid
diet.
AB - Twelve patients with progressive renal failure were placed on a very low
protein diet supplemented by an essential amino acid-keto acid mixture
for six to twelve months. Total daily intake was 0.04 g nitrogen/kg and
50 kcal/kg. Eight subjects had a significant change in the slope of
reciprocal plasma creatinine, becoming less steep and in two cases
positive. GFR did not improve, but in four patients the decline over
twelve months was less than 0.5 mliter/min. There were significant falls
in blood and urinary urea, serum phosphate PTH and calcium X phosphate
product. Body wt decreased during the first three months. Arm muscle
circumference fell by 0.9 cm (P less than 0.005). Serum albumin and
transferrin levels did not change significantly. Muscle mass and plasma
creatinine fell simultaneously in several patients. Creatinine excretion
per kg muscle mass, assessed anthropometrically, declined by 21% in the
first three months. This diet may slow the decline in renal function in a
proportion of patients. However, muscle mass can be lost. Serum protein
levels do not accurately reflect nutritional changes. A fall in plasma
creatinine may not be due to improved GFR but instead to altered
creatinine metabolism.
MH - Adult ; Amino Acids, Essential/*ADMINISTRATION & DOSAGE ; Body Weight ;
Creatinine/BLOOD ; Dietary Proteins/*ADMINISTRATION & DOSAGE ; Female ;
Glomerular Filtration Rate ; Human ; Keto Acids/*ADMINISTRATION & DOSAGE
; Kidney/PHYSIOPATHOLOGY ; Kidney Failure, Chronic/*DIET THERAPY/
PHYSIOPATHOLOGY ; Male ; Middle Age ; Muscles/ANATOMY & HISTOLOGY ; Risk
; Skinfold Thickness ; Support, Non-U.S. Gov't ; Time Factors
SO - Kidney Int 1986 May;29(5):995-1003
18
UI - 86254005
AU - Manley M ; Sweeney J
TI - Assessment of compliance in hemodialysis adaptation.
AB - Research in hemodialysis adaptation has been facilitated by the use of
reliable outcome measures such as BUN, K, and interdialysis weight gain.
Their use, however, has at times been impressionistic, without reference
to the actual range and distribution of those markers in a large
population of dialysis patients over a long period of time. This study is
a retrospective review to determine that range and distribution at one
center. We found the interdialysis weight gains for most patients to be
much higher than the levels used in the literature as cut-off points in
determining 'non-compliance'. High levels on non-compliance in previous
reports may be inflated. Significant correlations among the three
biological markers and between each marker and staff assessment of
compliance validate the use of inter-dialysis weight gain. Suggestions
are made for interpreting such data in the future.
MH - *Adaptation, Psychological ; Adult ; Blood Urea Nitrogen ; Body Weight ;
Female ; Hemodialysis/*PSYCHOLOGY ; Human ; Kidney Failure, Chronic/
*PSYCHOLOGY ; Male ; *Patient Compliance ; Potassium/BLOOD ; Seasons
SO - J Psychosom Res 1986;30(2):153-61
19
UI - 86253440
AU - Cole BR ; Schwartz D ; Manning PT ; Katsube NC ; Needleman P
TI - Atriopeptins: circulating volume regulatory hormones with potential
therapeutic role in chronic renal failure.
AB - Sprague-Dawley rats given bolus intravenous injections of
vasoconstrictors, including 1-deamino-Arg8-vasopressin (dAVP),
demonstrated remarkable increases in plasma immunoreactivity (APir) to
atriopeptin (AP). These elevations were accompanied by increases in
systemic blood pressure, right atrial pressure and urinary volume
excretion. Fractionated plasma APir peaks obtained by stimulation with
dAVP were identified as primarily AP 28, with a smaller amount of AP 24,
suggesting that AP 28 is the predominant circulating atrial peptide. Rats
with reduced renal mass have increased single-nephron glomerular
filtration rates (GFR). Despite these increases, AP 24 stimulated a
marked increase in total GFR and promoted a profound natriuresis and
diuresis. Atriopeptin 24 may therefore have potential as a therapeutic
tool in the management of volume overload in chronic renal failure.
MH - Animal ; Blood Pressure/DRUG EFFECTS ; Comparative Study ; Glomerular
Filtration Rate/DRUG EFFECTS ; Kidney Failure, Chronic/*DRUG THERAPY ;
Natriuresis/DRUG EFFECTS ; Natriuretic Peptides, Atrial/BLOOD/
*PHARMACODYNAMICS/THERAPEUTIC USE ; Peptide Fragments/BLOOD/
PHARMACODYNAMICS/THERAPEUTIC USE ; Rats ; Rats, Inbred Strains ;
Stimulation, Chemical ; Support, Non-U.S. Gov't ; Vasoconstrictor Agents/
PHARMACODYNAMICS
SO - J Hypertens [Suppl] 1986 Jun;4(2):S13-6
20
UI - 86246093
AU - Wilkins MR ; Wood JA ; Adu D ; Lote CJ ; Kendall MJ ; Michael J
TI - Change in plasma immunoreactive atrial natriuretic peptide during
sequential ultrafiltration and haemodialysis.
AB - Plasma immunoreactive human atrial natriuretic peptide (Ir-ANP) levels
were measured in eight patients with chronic renal failure who were
volume-expanded and during treatment by sequential ultrafiltration and
haemodialysis. One patient was studied at two separate treatment
sessions. Plasma Ir-ANP levels were raised in all patients (mean +/- SE
184 +/- 44 pmol/l, n = 9) compared with healthy controls (11 +/- 1.4
pmol/l), but showed considerable inter-patient variability. Plasma Ir-ANP
levels fell with fluid removal during ultrafiltration (123 +/- 30 pmol/l,
n = 9, P less than 0.02) and again as fluid was removed during
haemodialysis (76 +/- 20 pmol/l, n = 9, P less than 0.02). Seven patients
studied 48 h later, before their next dialysis treatment, had regained
weight and showed a coincident rise in circulating plasma Ir-ANP (130 +/-
33 pmol/l, n = 7). Our data would support the hypothesis that the
secretion of ANP is determined by volume or by a stimulus related to
volume. However, it does not exclude the possibility that a factor other
than extracellular fluid volume expansion contributes to the raised
plasma Ir-ANP levels in chronic renal failure.
MH - Adult ; Argipressin/BLOOD ; *Blood ; Blood Pressure ; Blood Urea Nitrogen
; Body Weight ; Female ; *Hemodialysis ; Human ; Kidney Failure, Chronic/
*BLOOD/THERAPY ; Male ; Middle Age ; Natriuretic Peptides, Atrial/*BLOOD
; Osmolar Concentration ; Potassium/BLOOD ; Radioimmunoassay ; Sodium/
BLOOD ; *Ultrafiltration
SO - Clin Sci 1986 Aug;71(2):157-60
21
UI - 86239312
AU - Kirschbaum BB
TI - Analysis of reciprocal creatinine plots in renal failure.
AB - The linearity that has frequently been observed when the reciprocal of
the serum creatinine is plotted against time of follow-up has been used
to predict the future course of patients with renal disease. In the
present study, we have analyzed reciprocal creatinine plots with a
computer program that identifies breakpoints in a linear plot and
calculates the statistical significance of the fit provided by two
intersecting lines instead of a single straight line. When applied to
cases of chronic renal failure, the program revealed breakpoints that
were not temporally related to recognized major clinical events. The
computer program may prove useful for evaluating the validity of data
derived from clinical trials of therapies to moderate the course of
declining kidney function.
MH - Adolescence ; Adult ; Case Report ; Creatinine/*BLOOD ; Female ; Human ;
Kidney Failure, Chronic/*BLOOD/DIAGNOSIS ; Kidney Function Tests ; Male ;
Middle Age ; Regression Analysis ; Retrospective Studies ; Time Factors
SO - Am J Med Sci 1986 Jun;291(6):401-4
22
UI - 86235258
AU - Jacobsen BA ; Fjeldborg P
TI - Renal haemodynamics during propranolol treatment in patients with
arterial hypertension and chronic renal failure.
AB - The effect of propranolol on renal haemodynamics was studied in nine
patients with arterial hypertension and moderate to severe chronic renal
failure. A reduction of the renal function in this type of patient might
have clinical consequence. The patients, whose glomerular filtration rate
(GFR) ranged between 17 ml/min/1.73 m2 and 71 ml/min/1.73 m2, were
studied during three 4-week periods with alternately placebo, propranolol
(40 mg b.i.d.) and placebo treatment. The GFR and the effective renal
plasma flow (ERPF) were determined as the plasma clearance of 51Cr-EDTA
and 125I-hippurane. The GFR fell on the average 7% (95% confidence
limits: 1-12%) during propranolol treatment, and the fall was reversible.
No changes were found in ERPF. In conclusion, propranolol treatment in
this type of patient causes a modest and reversible fall of GFR.
MH - Adult ; Female ; Glomerular Filtration Rate/DRUG EFFECTS ; Human ;
Hypertension/*DRUG THERAPY/PHYSIOPATHOLOGY ; Kidney Failure, Chronic/
*DRUG THERAPY/PHYSIOPATHOLOGY ; Male ; Middle Age ; Propranolol/
*THERAPEUTIC USE ; Renal Circulation/*DRUG EFFECTS ; Support, Non-U.S.
Gov't
SO - Scand J Clin Lab Invest 1986 May;46(3):289-92
23
UI - 86228665
AU - ter Wee PM ; Rosman JB ; van der Geest S ; Sluiter WJ ; Donker AJ
TI - Renal hemodynamics during separate and combined infusion of amino acids
and dopamine.
AB - Healthy volunteers (N = 9) and patients with varying degrees of renal
insufficiency (N = 36) were given a low dose of dopamine and/or amino
acids intravenously during a simultaneous measurement of the glomerular
filtration rate and the effective renal plasma flow. Dopamine infusion
led to a rise in the glomerular filtration rate and a fall in the
filtration fraction. Infusion of amino acids was accompanied by an
increase in the glomerular filtration rate while the filtration fraction
remained unchanged or increased slightly. The highest values for the
glomerular filtration were obtained during the combined infusion of amino
acids and dopamine. A reserve in filtration capacity was not or hardly
present in patients with moderate (GFR 30 to 90 mliter/min/1.73 M2) to
severe (GFR less than 30 mliter/min/1.73 M2) renal insufficiency. We
conclude that dopamine decreases total renal vascular resistance while
amino acids mainly reduce the tone of afferent arterioles. As amino acids
and dopamine seem to be additive in their effects on the glomerular
filtration rate, we recommend the combined infusion of these two stimuli
to measure renal reserve filtration capacity.
MH - Amino Acids/*THERAPEUTIC USE ; Dopamine/*THERAPEUTIC USE ; Drug Therapy,
Combination ; Glomerular Filtration Rate/DRUG EFFECTS ; Hemodynamics/
*DRUG EFFECTS ; Human ; Infusions, Parenteral ; Kidney Failure, Chronic/
*DRUG THERAPY ; Renal Circulation/*DRUG EFFECTS ; Rheology ; Support,
Non-U.S. Gov't ; Urodynamics/DRUG EFFECTS
SO - Kidney Int 1986 Apr;29(4):870-4
24
UI - 86227842
AU - Cohen JR ; Mannick JA ; Couch NP ; Whittemore AD
TI - Abdominal aortic aneurysm repair in patients with preoperative renal
failure.
AB - The purpose of this study was to determine the effect of preoperative
renal failure on the outcome of patients undergoing infrarenal abdominal
aortic aneurysm (AAA) repair. Of 251 patients undergoing AAA repair from
1977 to 1984, 10% had evidence of preoperative chronic renal failure.
These patients were classified according to their preoperative serum
creatinine values; group I had preoperative creatinine levels of 2 to 4
mg/dl, group II had creatinine levels greater than 4 mg/dl but no history
of hemodialysis, and group III consisted of patients on chronic
hemodialysis before operation. One of 16 patients in group I developed
transient high-output renal failure postoperatively. Four of the six
patients in group II (67%) developed significant postoperative
deterioration of renal function and required acute hemodialysis. Of the
four patients in group III maintained on chronic hemodialysis
preoperatively, one died of sepsis from an ischemic colon. This
experience suggests that patients with mild renal dysfunction (serum
creatine value less than 4 mg/dl) can undergo elective AAA repair without
additional morbidity. Patients on hemodialysis before operation can also
safely undergo surgical repair of their AAAs electively if dialyzed the
day before operation. Patients with severe renal dysfunction (serum
creatinine greater than 4 mg/dl) who are not on hemodialysis should be
considered for dialysis preoperatively in an attempt to reduce the high
incidence of serious postoperative renal functional deterioration and
subsequent morbidity.
MH - Aorta, Abdominal/SURGERY ; Aortic Aneurysm/COMPLICATIONS/*SURGERY ;
Creatinine/DIAGNOSTIC USE ; Hemodialysis ; Human ; Kidney Failure,
Chronic/*COMPLICATIONS/THERAPY ; Kidney Function Tests ; Postoperative
Complications/*ETIOLOGY/THERAPY ; Preoperative Care ; Retrospective
Studies ; Risk
SO - J Vasc Surg 1986 Jun;3(6):867-70
25
UI - 86191020
AU - Mistry CD ; Lote CJ ; Currie WJ ; Vandenburg M ; Mallick NP
TI - Effects of sulindac on renal function and prostaglandin synthesis in
patients with moderate chronic renal insufficiency.
AB - The renal effects of therapeutic doses of sulindac were studied in nine
patients with stable renal insufficiency, mean creatinine clearance 37.0
+/- 2.2 ml min-1 1.73 m-2 (range 24.7-54.6 ml min-1 1.73 m-2). Nine days'
treatment with sulindac produced a small, but significant, reduction in
the mean creatinine clearance (37.0 +/- 2.2 to 34.7 +/- 2.2 ml min-1 1.73
m-2; P less than 0.02) and 99mTc diethylenetriaminepenta-acetate (DTPA)
clearance (35.5 +/- 3.4 to 31.4 +/- 3.6 ml min-1 1.73 m-2; P less than
0.02) without altering body weight, effective renal plasma flow
[131I]hippuran clearance), plasma renin activity (PRA), 24 h urinary
volume or electrolyte excretion. After discontinuation of sulindac,
creatinine clearance returned to pretreatment values. In five female
patients, pretreatment urinary excretion of the 6-ketoprostaglandin F1
alpha (6-keto-PGF1 alpha), a stable breakdown product of prostacyclin
(PGI2), was significantly reduced (P less than 0.02) when compared with
four healthy controls, whereas prostaglandin E2 (PGE2) was unchanged.
Administration of sulindac did not significantly alter the excretion rate
of PGE2 or 6-ketoPGF1 alpha in this group of patients. In chronic renal
disease with moderate renal impairment, reduced renal prostacyclin
synthesis may be an important predisposing factor to the renal toxicity
associated with the use of non-steroidal anti-inflammatory drugs (NSAID).
Short term use of sulindac in therapeutic doses does not appear to
influence the excretion of prostaglandins and produces only a minor
reversible change in renal function; used cautiously it may have
advantages over other NSAID in these patients.
MH - Adult ; Creatinine/URINE ; Female ; Glomerular Filtration Rate ; Human ;
Indenes/*THERAPEUTIC USE ; Kidney/BLOOD SUPPLY/PHYSIOPATHOLOGY ; Kidney
Failure, Chronic/*DRUG THERAPY/PHYSIOPATHOLOGY ; Male ; Prostaglandins/
*URINE ; Prostaglandins E/URINE ; Renin/BLOOD ; Sulindac/*THERAPEUTIC USE
; Support, Non-U.S. Gov't ; 6-Ketoprostaglandin F1 alpha/URINE
SO - Clin Sci 1986 May;70(5):501-5
26
UI - 86214888
AU - Craswell PW ; Price J ; Boyle PD ; Heazlewood VJ ; Baddeley H ; Lloyd HM
; Thomas BJ ; Thomas BW ; Williams GM
TI - Chronic lead nephropathy in Queensland: alternative methods of diagnosis.
AB - Indices of past lead absorption were measured and compared in patients
with chronic renal failure from many causes, including some with chronic
lead nephropathy. X-ray fluorescence (XRF) yielded finger bone lead
concentrations by a new in vivo method. These correlated significantly
with excess urinary lead following calcium di-sodium EDTA
(ethylenediamine tetra-acetate) and erythrocyte lead concentration.
Discriminant function analysis demonstrated that the patients in the
study could be separated into two groups without any reference to the
EDTA lead excretion test using the following variables, all of which
contributed significantly to the discrimination. In order of importance,
these were: a childhood history of acute lead poisoning, a history of
gout, a family history of gout and detectable XRF finger bone lead.
Although the XRF finger bone lead measurement is convenient and
non-invasive, its lack of sensitivity (48%) limits its usefulness as a
screening test for chronic lead nephropathy.
MH - Aged ; Bone and Bones/ANALYSIS ; Comparative Study ; EDTA/DIAGNOSTIC USE
; Female ; Gout/FAMILIAL & GENETIC ; Human ; Kidney/METABOLISM/
PHYSIOPATHOLOGY ; Kidney Failure, Chronic/CHEMICALLY INDUCED/*DIAGNOSIS/
METABOLISM ; Kidney Function Tests ; Lead/ANALYSIS/METABOLISM ; Lead
Poisoning/*DIAGNOSIS/METABOLISM/PSYCHOLOGY ; Male ; Middle Age ;
Psychological Tests ; Spectrometry, X-Ray Emission ; Support, Non-U.S.
Gov't
SO - Aust NZ J Med 1986 Feb;16(1):11-9
27
UI - 86212748
AU - Friend R ; Singletary Y ; Mendell NR ; Nurse H
TI - Group participation and survival among patients with end-stage renal
disease.
AB - All 126 End-Stage Renal Disease (ESRD) patients who entered dialysis
between 1971 and 1981 at the Harlem Hospital Center, New York City, were
separated into those who had participated in a patient support group and
those who had not done so. Patients who engaged in the group activities
survived considerably longer than non-participants. Family history of
renal disease, psychiatric illness, blood urea nitrogen (BUN), and
creatinine were also related to survival, but, education, religion,
marital status, and age were not. When 13 psychosocial and physiological
covariates were controlled for in a Cox proportional hazard analysis, the
group participation effect remained substantial.
MH - Blood Urea Nitrogen ; Comparative Study ; Creatinine/ISOLATION &
PURIFICATION ; Educational Status ; Female ; *Hemodialysis ; Human ;
Kidney Failure, Chronic/COMPLICATIONS/ETIOLOGY/*PSYCHOLOGY/THERAPY ;
Longevity ; Male ; Mental Disorders/COMPLICATIONS/FAMILIAL & GENETIC ;
Middle Age ; Prognosis ; *Social Environment ; *Social Support ; Urban
Population
SO - Am J Public Health 1986 Jun;76(6):670-2
28
UI - 86205594
AU - Eknoyan G
TI - Chronic renal failure. The primary care physician's role.
AB - Recent developments in understanding of the pathophysiology of chronic
renal failure have provided a sound basis for several measures which,
when instituted early in the course of renal disease, can delay
progression to end-stage kidney disease and considerably improved the
symptoms of uremic syndrome. This article outlines the key role that the
primary care physician plays in early diagnosis of chronic renal disease
and institution of appropriate therapy well before the nephrologist's
services are needed.
MH - Absorption ; Blood Urea Nitrogen ; Calcium/THERAPEUTIC USE ; Creatinine/
ISOLATION & PURIFICATION ; Dietary Proteins/ADMINISTRATION & DOSAGE ;
Glomerular Filtration Rate ; Hemoglobins ; Homeostasis ; Human ;
Hypertension/ETIOLOGY ; Kidney Failure, Chronic/COMPLICATIONS/ETIOLOGY/
*PHYSIOPATHOLOGY/THERAPY ; Kidney Glomerulus/PATHOLOGY ; Patient
Education ; Social Support ; Uremia/ETIOLOGY/PHYSIOPATHOLOGY
SO - Postgrad Med 1986 May 1;79(6):221-6, 228-30
29
UI - 86201321
AU - Kopple JD ; Monteon FJ ; Shaib JK
TI - Effect of energy intake on nitrogen metabolism in nondialyzed patients
with chronic renal failure.
AB - Dietary energy requirements were evaluated during 16 studies that were
carried out in six clinically stable nondialyzed chronically uremic
patients who lived in a clinical research center and were fed diets
providing 45, 35, 25 or 15 kcal/kg/day. Each diet was fed for 23.7 +/-
5.7 SD days and provided about 0.55 to 0.60 g protein/kg/day. Nitrogen
balance after equilibration and adjusted for changes in body urea
nitrogen, and change in body weight each correlated directly with energy
intake. Correcting for estimated unmeasured nitrogen losses of about 0.58
g/day, nitrogen balance was negative in one of four patients fed 45
kcal/kg/day, one of five patients receiving 35 kcal/kg/day, three of five
patients ingesting 25 kcal/kg/day and both patients fed 15 kcal/kg/day.
The urea nitrogen appearance (UNA), the UNA divided by nitrogen intake,
and several plasma amino acids, determined after an overnight fast, each
correlated inversely with dietary energy intake. Resting energy
expenditure measured by indirect calorimetry did not differ from normal
and averaged 0.012 +/- 0.0033 kcal/kg/min with the different diets. These
observations suggest that although some clinically stable nondialyzed
chronically uremic patients ingesting 0.55 to 0.60 g protein/kg/day may
maintain nitrogen balance with energy intakes below 30 kcal/kg/day, a
dietary intake providing approximately 35 kcal/kg/day may be more likely
to maintain neutral or positive nitrogen balance, maintain or increase
body mass, and reduce net urea generation.
MH - Amino Acids/BLOOD ; Blood Proteins/METABOLISM ; Blood Urea Nitrogen ;
Body Weight ; *Caloric Intake ; Dietary Proteins/*ADMINISTRATION & DOSAGE
; Energy Metabolism ; Female ; *Hemodialysis ; Human ; Kidney Failure,
Chronic/*DIET THERAPY/METABOLISM ; Male ; Middle Age ; Nitrogen/
*METABOLISM ; Skinfold Thickness ; Support, Non-U.S. Gov't ; Support,
U.S. Gov't, Non-P.H.S. ; Support, U.S. Gov't, P.H.S.
SO - Kidney Int 1986 Mar;29(3):734-42
30
UI - 86201311
AU - Lumlertgul D ; Burke TJ ; Gillum DM ; Alfrey AC ; Harris DC ; Hammond WS
; Schrier RW
TI - Phosphate depletion arrests progression of chronic renal failure
independent of protein intake.
AB - Following 5/6 nephrectomy, 18 rats were fed a normal diet. After 30 days,
serum creatinine (SCr), urine protein excretion and urine volume were
increased compared to pre-nephrectomy (0.27 +/- 0.1 vs. 1.62 +/- 0.6
mg/deciliter, 17.0 +/- 10.3 vs. 257.6 +/- 13.4 mg/24 hr, and 16.6 +/- 4.4
vs. 39.2 +/- 11.7 ml/24 hr, respectively, all P less than 0.001). At this
time, when serum phosphorus (SPi) and serum calcium (SCa2+) were normal,
the rats were separated into two groups, matched and paired by body
weight and SCr, and housed separately in metabolic cages. Animals of one
group ingested a normal diet supplemented with dihydroxyaluminum
aminoacetate (DHAAA), 15 g%, to induce phosphate depletion (PD). The
second group ingested the same diet supplemented with 7.5% glycine and
was the phosphate replete (PR) group. All rats were pair fed throughout
the study to maintain similar caloric, protein, carbohydrate, vitamin,
and mineral intakes. At six weeks after separation, SPi was decreased in
PD vs. PR group (2.85 +/- 0.8 vs. 6.71 +/- 1.2 mg/deciliter, P less than
0.001) and SCa2+ was increased in the PD group (11.98 +/- 0.7 vs. 10.03
+/- 0.7 mg/deciliter, P less than 0.001). Urine urea nitrogen, body
weight, and sodium, potassium and solute excretion were similar between
the groups.(ABSTRACT TRUNCATED AT 250 WORDS)
MH - Aluminum Hydroxide/ADMINISTRATION & DOSAGE ; Animal ; Blood Pressure ;
Blood Urea Nitrogen ; Calcium/BLOOD ; Cholesterol/BLOOD ; Creatinine/
BLOOD ; Dietary Proteins/*ADMINISTRATION & DOSAGE ; Food ; Glycine/
ANALOGS & DERIVATIVES/ADMINISTRATION & DOSAGE ; Kidney Failure, Chronic/
BLOOD/*DIET THERAPY ; Male ; Nephrectomy ; Phosphates/*ADMINISTRATION &
DOSAGE ; Phosphorus/BLOOD ; Rats ; Rats, Inbred Strains ; Serum Albumin/
ANALYSIS ; Support, Non-U.S. Gov't ; Support, U.S. Gov't, Non-P.H.S. ;
Triglycerides/BLOOD
SO - Kidney Int 1986 Mar;29(3):658-66
31
UI - 86196850
AU - Garg DC ; Baltodano N ; Jallad NS ; Perez G ; Oster JR ; Eshelman FN ;
Weidler DJ
TI - Pharmacokinetics of ranitidine in patients with renal failure.
AB - The pharmacokinetics of ranitidine were studied in ten patients with
renal failure (creatinine clearance, 6-54 mL/min) after intravenous (IV)
(50 mg) and oral doses (150 mg). After oral administration, peak plasma
concentrations of 378-808 ng/mL were obtained in two to six hours. Plasma
concentrations declined very slowly and concentrations greater than 100
ng/mL were obtained for 16 to 20 hours after the dose. The elimination
half-life following oral administration was 8.5 +/- 2.8 hours (standard
deviation [SD]), and the bioavailability of ranitidine was 43.3% +/-
10.5%. After IV administration, the elimination half-life, plasma
clearance, renal clearance, and volume of distribution were 7.0 +/- 1.0
hours, 170 +/- 38 mL/min, 36.0 +/- 25.0 mL/min, and 1.3 +/- 0.4 L/kg,
respectively. About 20% of the IV dose and 9% of the oral dose were
recovered unchanged in urine. There was a significant correlation between
the renal clearance of ranitidine and creatinine clearance (r = .74, P
less than .05) after IV administration. The elimination half-life in
patients with renal insufficiency is about three times greater than that
reported in the literature for healthy subjects. Similarly, the plasma
clearance in these patients is about 20% of that reported in healthy
subjects. The results indicate that ranitidine elimination is appreciably
reduced in renal failure and that an adjustment of dose in patients with
renal failure is warranted. A dose of 75 mg bid may be adequate in
maintaining the therapeutic plasma concentrations that are required for
adequate H2-blocking activity.
MH - Aged ; Biological Availability ; Blood Urea Nitrogen ; Creatinine/BLOOD ;
Half-Life ; Human ; Infusions, Parenteral ; Kidney Failure, Chronic/
*BLOOD ; Kinetics ; Male ; Metabolic Clearance Rate ; Middle Age ;
Ranitidine/*BLOOD
SO - J Clin Pharmacol 1986 Apr;26(4):286-91
32
UI - 86190714
AU - Yamauchi A ; Fujii M ; Shirai D ; Mikami H ; Okada A ; Imai E ; Ando A ;
Orita Y ; Kamada T
TI - Plasma concentration and peritoneal clearance of oxalate in patients on
continuous ambulatory peritoneal dialysis (CAPD).
AB - Accumulation of oxalate, resulting in high plasma levels, is a common
finding in end-stage renal disease. We investigated plasma concentration
and peritoneal clearance of oxalate in 14 patients on continuous
ambulatory peritoneal dialysis. The plasma oxalate levels in these
patients (30.2 +/- 11.2 mumol/l) were as high as those in hemodialysis
patients before dialysis (31.9 +/- 11.1 mumol/l). There was a significant
correlation between plasma oxalate and urea nitrogen appearance (UNA).
Dietary protein seems to be an important oxalate source in these
patients, because the UNA reflects protein intake in stable patients. The
mean peritoneal oxalate clearance was 6.64 +/- 1.56 l/day, close to the
creatinine clearance. These results suggest that the plasma oxalate
levels in CAPD patients may be sufficiently high to induce calcium
oxalate deposition, and that methods of increasing oxalate removal and
reducing oxalate burden are necessary for CAPD patients.
MH - Adolescence ; Adult ; Aged ; Blood Urea Nitrogen ; Comparative Study ;
Dietary Proteins/ADMINISTRATION & DOSAGE ; Female ; Hemodialysis ; Human
; Kidney Failure, Chronic/BLOOD/*THERAPY ; Male ; Middle Age ; Oxalates/
*BLOOD/METABOLISM ; *Peritoneal Dialysis, Continuous Ambulatory
SO - Clin Nephrol 1986 Apr;25(4):181-5