{"title":"The sympathetic nervous system in the pathogenesis of acute renal failure.","authors":"A Iaina, H E Eliahou","doi":"10.3109/08860228309076043","DOIUrl":"https://doi.org/10.3109/08860228309076043","url":null,"abstract":"<p><p>The purpose of this review is to highlight the participation and the possible role of the renal sympathetic nervous system in the development of renal cell damage and the consequent dysfunctions and filtration filtration failure.</p>","PeriodicalId":79208,"journal":{"name":"Clinical and experimental dialysis and apheresis","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1983-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3109/08860228309076043","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"17371071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
P Wunderlich, M Hermle, J M Davis, M Mihatsch, F Brunner, G Thiel
{"title":"The role of tubuloglomerular feedback in acute impairment of renal function in obstructive jaundice.","authors":"P Wunderlich, M Hermle, J M Davis, M Mihatsch, F Brunner, G Thiel","doi":"10.3109/08860228309076040","DOIUrl":"https://doi.org/10.3109/08860228309076040","url":null,"abstract":"<p><p>Acute renal functional impairment not infrequently accompanies liver dysfunction and, particularly with bile duct obstruction, may be extremely severe. Recent studies suggest that tubuloglomerular feedback (TGF) activated by circulating non-electrolyte factors which occur during liver dysfunction may contribute to the intense renal vasoconstriction thought to be central to the functional renal impairment. In this study, serum from two patients with obstructive jaundice (OJ) and renal impairment, and from rats with OJ due to bile duct ligation were either dialysed or treated with furosemide, known to block electrolyte-mediated TGF. These sera, when perfused into loops of Henle in rat nephrons, induced a significant fall of 28% in stop-flow pressure, an indirect measure of glomerular capillary pressure thus implying arteriolar vasoconstriction. These findings are consistent with the hypothesis that circulating, non-electrolyte factors, which stimulate TGF, occur in cases of obstructive jaundice and that these may contribute to the renal impairment.</p>","PeriodicalId":79208,"journal":{"name":"Clinical and experimental dialysis and apheresis","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1983-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3109/08860228309076040","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"17933395","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Adrenal responsiveness during and after intermittent haemodialysis.","authors":"D Grekas, A Tourkantonis, A Pharmakiotis","doi":"10.3109/08860228309076049","DOIUrl":"https://doi.org/10.3109/08860228309076049","url":null,"abstract":"<p><p>ACTH and cortisol were measured by radioimmunoassay in 15 patients undergoing long term haemodialysis. Also a basal ACTH stimulation test was done by administration of 250 micrograms of Synachten (Synthetic ACTH, CIBA foundation) and the results compared with those of normal controls and end-stage chronic renal failure patients (CRF). All 15 had been receiving intermittent haemodialysis three times weekly for 5 hours on a twin coil dialyser. The duration of dialysis was from 6 to 20 months and the mean value of pre - dialysis serum creatinine was 1093 +/- 182 mumol/l. Both hormones had significantly risen in the middle and at the end of dialysis (p less than 0.005), While they had fallen back to normal mean levels 24 hours after dialysis. The Synachten stimulation test showed that adrenal response was within normal limits in both groups of patients, but dialysis patients responded significantly better (p less than 0.05) than patients with end stage CRF. We concluded that the adrenal responsiveness is within normal limits during and after regular haemodialysis and our likely explanation is a fall in plasma volume produced by the extracorporeal circulation and the increased turnover of cortisol during haemodialysis.</p>","PeriodicalId":79208,"journal":{"name":"Clinical and experimental dialysis and apheresis","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1983-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3109/08860228309076049","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"17384202","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The liaison psychiatrist and the outpatient hemodialysis unit. Part I: Reliability and validity of staff assessments of patient compliance on a hemodialysis unit.","authors":"M Manley","doi":"10.3109/08860228309076062","DOIUrl":"https://doi.org/10.3109/08860228309076062","url":null,"abstract":"<p><p>The use of staff ratings as an outcome measure in adaptation to hemodialysis studies is discussed, and the absence of reliability or validity of such ratings is emphasized. Staff ratings for global impressions of patient compliance are collected in an outpatient hemodialysis unit, inter-rater reliability is calculated, and the rating averages are correlated with three biological markers. A high degree of exact inter-rater agreement is found and correlation of ratings with inter-dialysis weight gain, mean BUN, and mean K are determined.</p>","PeriodicalId":79208,"journal":{"name":"Clinical and experimental dialysis and apheresis","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1983-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3109/08860228309076062","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"17730567","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Prognostic patterns in acute renal failure: the New York Hospital, 1981-1982.","authors":"M C Frankel, A M Weinstein, K H Stenzel","doi":"10.3109/08860228309076045","DOIUrl":"https://doi.org/10.3109/08860228309076045","url":null,"abstract":"<p><p>Sixty four patients who developed acute renal failure at The New York Hospital between July 1981 and June 1982 were studied. The average age was found to be 59.5 years. The overall mortality rate was 62.5%. Patients with non-oliguric renal failure had a lower mortality rate (25%) than those with oliguric renal failure (79%). Those patients with non-oliguric renal failure were more likely to have a discrete cause of renal failure (drugs) and to be in a more stable cardiovascular status. Tachycardia, hypotension, respiratory failure, and documented (or presumed) sepsis all adversely affected prognosis.</p>","PeriodicalId":79208,"journal":{"name":"Clinical and experimental dialysis and apheresis","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1983-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3109/08860228309076045","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"17933393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Compensatory hypertrophy of single nephrons following ischemic injury in the rat.","authors":"W F Finn","doi":"10.3109/08860228309076042","DOIUrl":"https://doi.org/10.3109/08860228309076042","url":null,"abstract":"<p><p>In Sprague-Dawley rats, the increase in single nephron glomerular filtration rate (SNGFR) following uninephrectomy is due to an increase in glomerular plasma flow (GPF) along with an increase in the glomerular capillary ultrafiltration coefficient (Kf). Hypertrophy of individual nephrons also occurs when renal mass is reduced by disease or ischemic injury. To characterize the factors determining SNGFR in the minority of nephrons that recover from a severe ischemic insult, rats were studied 4 weeks after 1 hour of complete unilateral renal artery occlusion and the results compared to those obtained in normal rats. Indirect determination of the dynamics of glomerular ultrafiltration along with microangiographic studies indicated that despite a reduction in total renal blood flow in the postischemic kidney, a minority of nephrons were hyperperfused. The increase of GPF in these nephrons along with a significant increase in Kf was responsible for the observed increase in SNGFR.</p>","PeriodicalId":79208,"journal":{"name":"Clinical and experimental dialysis and apheresis","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1983-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3109/08860228309076042","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"17933574","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
H J Kramer, A Neumark, S Schmidt, D Klingmüller, K Glänzer
{"title":"Renal functional and metabolic studies on the role of preventive measures in experimental acute ischemic renal failure.","authors":"H J Kramer, A Neumark, S Schmidt, D Klingmüller, K Glänzer","doi":"10.3109/08860228309076041","DOIUrl":"https://doi.org/10.3109/08860228309076041","url":null,"abstract":"<p><p>In the present study 1 h of total occlusion of the left renal artery in conscious rats was chosen as experimental model of ischemic acute renal failure (ARF), while the contralateral kidney was left intact. Chronic high dietary sodium intake, acute isotonic saline infusion, or administration of saralasin did not protect from ARF. Furosemide, mannitol, and verapamil converted oliguric into non-oliguric ARF in 100%, 75%, and 60% of the animals, resp. Protection from oliguria and preservation of GFR inversely correlated with the depression of cortical ATP-concentration (control: 1.32 +/- 0.07 mumoles/g wet weight) 6 h after ischemia by 16%, 41%, and 58% in mannitol- and verapamil- treated rats and in untreated rats, resp. At this time, Na-K-ATPase enzyme activities in renal cortex and papilla were unaffected, while enzyme activity in outer medulla was suppressed from 15.4 +/- 1.4 to 9.4 +/- 1.0 mumoles Pi/mg protein h in all groups of animals. The results suggest that in this model of ARF renal ischemia not only affects cellular energy supply in renal cortex but also causes severe structural and functional impairment in the outer medulla, probably leading to tubular obstruction and depression of glomerular function. Pharmacological protection from ischemic oliguric ARF cannot be achieved by prior induction of high urine flow rates alone but depends on the degree of metabolic and functional reserve of the injured tubular epithelium.</p>","PeriodicalId":79208,"journal":{"name":"Clinical and experimental dialysis and apheresis","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1983-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3109/08860228309076041","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"17470381","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"When transplantation is not the answer.","authors":"P G Wilson","doi":"10.3109/08860228309076060","DOIUrl":"https://doi.org/10.3109/08860228309076060","url":null,"abstract":"<p><p>In this paper, the author emphasizes the need for thorough in-depth pre-renal transplant evaluation, in an effort to weed out the patients who might have increasing difficulties from this procedure. Patient cases are described and discussed.</p>","PeriodicalId":79208,"journal":{"name":"Clinical and experimental dialysis and apheresis","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1983-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3109/08860228309076060","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"17433548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A pharmacokinetic evaluation of the effect of plasma exchange on tobramycin disposition.","authors":"S M Ouellette, J A Visconti, M S Kennedy","doi":"10.3109/08860228309076052","DOIUrl":"https://doi.org/10.3109/08860228309076052","url":null,"abstract":"<p><p>The effect of plasma exchange on the disposition of tobramycin was studied in three procedures done on two patients. Serum tobramycin levels were obtained when the subjects were off plasma exchange to calculate individualized tobramycin pharmacokinetic parameters. The amount of drug removed was measured and serum levels were obtained during plasma exchange. The effect of the procedure was evaluated by calculating the percentage of total body stores removed and comparing drug elimination half-life data on and off plasma exchange. The procedures resulted in the removal of 6.1%, 5.9% and 4.3% of total body stores of tobramycin. Plasma exchange provides an additional route of elimination for tobramycin which should be considered when dosing the drug in patients undergoing this procedure.</p>","PeriodicalId":79208,"journal":{"name":"Clinical and experimental dialysis and apheresis","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1983-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3109/08860228309076052","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"17726379","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A CAPD patient group on sexuality--a critical view.","authors":"U Davenport, L Strawgate-Kanefsky","doi":"10.3109/08860228309076058","DOIUrl":"https://doi.org/10.3109/08860228309076058","url":null,"abstract":"<p><p>This article describes the experience with a social work group on sexuality and analyzes the results critically. Patient groups have been widely described in the social work literature. For ESRD patients the group approach has been found to be particularly useful and the patient's ability to help each other with the many problems in dealing with psychological, social and economic life changes has been valued. The issue of sexuality in ESRD patients has also been frequently discussed although no references have been made to groups on sexuality.</p>","PeriodicalId":79208,"journal":{"name":"Clinical and experimental dialysis and apheresis","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1983-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3109/08860228309076058","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"17730565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}