Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0028961 (oliguria)
 1,847 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

With improving standards of antenatal care, severe pre-eclampsia dn eclampsia are becoming less common and experience in the management of these conditions is lessening. Co-ordinated plans for the care of patients should be established by obstetricians and anaesthetists working as a team. A suitable regime for drug therapy in severe pre-eclampsia or eclampsia is the following: Initial management Diazepam 10 mg slowly i.v. Pethidine 100-150 mg i.m. or i.v. in incremental dosage, or extradural blocks, if analgesia is also required. Hydrallazine 20 mg i.v. initially, followed by 5 mg at intervals of 20 min until the diastolic pressure is less than 110 mm Hg. Then, preferably by syringe pump in a concentration of 2 mg/ml, at a rate of 2-20 mg/h. If vomiting occurs this can be controlled by administration of atropine. Subsequent management Sedation and anticonvulsant therapy. Continue diazepam and, in severe cases, institute chlormethiazole infusion. Continue analgesia with pethidine or extradural block. Control of hypertension by adjusting the dose of hydrallazine. If tachycardia exceeds 120 beat/min give propanolol 2-4 mg i.v. Plasma protein depletion with groww oedema is treated by administration of salt-free albumin or plasma protein fraction. Diuretic therapy is indicated if there is gross oedema or signs suggestive of acute renal failure. Oliguria associated with increased blood urea may be a result of renal failure or dehydration. The latter should be evident from the patient's condition and central venous pressure, but i.v. fluids and frusemide 20-40 mg can be used as a therapeutic test. Mannitol reduces cerebral oedema and may be given if diuresis has been first produced with frusemide. Potassium chloride is given if the plasma potassium decreases to less than 3 mmol/litre. Heparin therapy is considered if there is clinical evidence of disseminated intravascular coagulation.
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PMID:The management of severe pre-eclampsia and eclampsia. 83 44

Ultrastructural changes in the visceral epithelium and proximal tubules of rats were studied by scanning and transmission electron microscopy during the onset and progression of puromycin aminonucleoside nephrosis (PAN)-induced proteinuria. These changes were compared with those that occur during a similar degree of proteinuria induced by intraperitoneal injections of albumin. With the onset of proteinuria and oliguria, PAN rats exhibit loss of podocyte pedicels and podocyte major processes, an increase in pinocytotic activity, and an accumulation of cytoplasmic vacuoles and granules of variable size, shape, and electron density. Loss of podocyte pedicels involves a gradual decrease in pedicel height beginning at the pedicel tip and progressing down the pedicel arm, formation of nublike protrusions and interpedicel microbridges (35 to 45 nm. in width and 40 to 60 nm. in length) along the pedicel's base, the merging of microbridges to form more extensive regions of interpedicel contact, and a gradual broadening and retraction of pedicels. In response to hyperalbuminemia-induced proteinuria, kidney podocytes exhibit reactions during PAN, however, the podocyte pedicels, slit pores, and major processes of rats with hyperalbuminemia-induced proteinuria remain discrete. The loss of pedicels and major processes during PAN, therefore, apparently results from the effects of puromycin aminonucleoside per se rather than from the proteinuria associated with this disease. The proximal tubules of rats with hyperalbuminemia-induced proteinurea exhibit the same characteristic changes as PAN rat proximal tubules (i.e., loss of brush border, dilated lumina, abnormally thin walls, and accumulation of periodic acid-Schiff positive electron-dense luminal casts and cytoplasmic protein absorption droplets). The significance of these ultrastructural findings during PAN and hyperalbuminemia-induced proteinurea are discussed in terms of the etiology of PAN.
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PMID:A scanning and transmission electron microscopic comparison of puromycin aminonucleoside-induced nephrosis to hyperalbuminemia-induced proteinuria with emphasis on kidney podocyte pedicel loss. 83 33

Autotransfusion in a canine model (n = 15) causes anemia, thrombocytopenia, hypofibrinogenemia, hypalbuminemia, and metabolic acidosis and enhances elimination of intravenously injected 131I albumin. Contact of the shed blood with the peritoneal surface aggravates the pathologic findings; without simultaneous intraperitoneal heparinization the highest rates of hemolysis with concomitant oliguria were observed.
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PMID:[Blood coagulation disorder, hemolysis and hypoalbuminemia after autotransfusion in experimental intraperitoneal hemorrhages]. 103 30

The treatment of drug overdose with drug-specific antibody fragments may require very high antibody doses. To address the feasibility of this therapy, we studied the pharmacokinetics and toxicity of high-dose human nonspecific Fab fragments in beagles. Three dogs received 5.3 g/kg Fab iv over 1 hr. Because nephrotoxicity was observed, three subsequent dogs received 3.2 g/kg. The fraction of the Fab dose excreted in urine (10 +/- 6%) was lower than reported values for either high or low doses of Fab in other species. The terminal serum elimination half-life (42 hr for the higher and 48 hr for the lower dose) was also longer than reported values for other species, due to lower renal and nonrenal Fab clearance. Fab administration was tolerated without adverse hemodynamic effects. One of three dogs at each dose developed transient oliguria. All dogs developed a transient but marked increase in the serum creatinine concentration. At 2 weeks creatinine clearance had returned to normal. Urinary protein and albumin excretion at 2 weeks were within the normal range for dogs but were increased over their baseline values. The histology of all organs was normal at 3 weeks by light microscopy, and renal histology by electron microscopy was also normal. The mechanism of Fab nephrotoxicity, not observed previously with high-dose Fab in rats or lower doses of Fab in other species including dogs, is not clear. These data suggest that further study of the potential toxicity of high-dose Fab, and its reversibility, is needed to assess the feasibility of treating drug overdose with this antibody fragment.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Rapid administration of high-dose human antibody Fab fragments to dogs: pharmacokinetics and toxicity. 191 83

There are three phases of acute hemorrhagic shock after trauma. In phase I (from injury to operation for control of bleeding) the patient suffers from low cardiac output, tachycardia, reduced organ perfusion, oliguria and decreased capillary hydrostatic pressure, which in turn reduces extravascular fluid loss. Contraction of the interstitial space matrix replenishes plasma volume. Optimal therapy includes blood and crystalloid replacement to restore plasma volume, red cell mass and interstitial fluid. Three litres of crystalloid are usually required for each litre of blood lost. After operation, a period of obligatory extravascular fluid sequestration occurs as the intracellular and interstitial spaces expand (phase II). Optimal replacement therapy during this phase maintains plasma volume. Replacement is provided according to the patient's vital signs, because extravascular fluid expansion cannot be influenced by therapeutic manipulation. Phase III is a mobilization and diuretic phase. During this phase systolic hypertension may occur, and the patient must be treated with restriction of fluid, diuresis and careful monitoring of the heart and lungs. Attempts to alter these physiologic responses with supplemental albumin have proved detrimental. The albumin causes salt and water retention in the nephron, leading to weight gain, higher central filing pressures and worsening pulmonary function, and a greater need for diuretic and inotropic therapy. Albumin therapy also induces relocation of non-albumin proteins into the interstitial space, leading to impaired immunocompetence and coagulation. Successful resuscitation is facilitated by adaptation to these physiologic responses of hemorrhagic shock rather than manipulation of them.
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PMID:Update on trauma care in Canada. 4. Resuscitation through the three phases of hemorrhagic shock after trauma. 225 21

Administration of a single oral dose of 60 mg/kg O,O,S-trimethyl phosphorothioate (OOS-Me), a malathion impurity, resulted in a substantial increase in the amounts of amino acids along with a change in the nature of proteins excreted in the urine of treated rats. In contrast to control rats, a small increase in albumin and a small decrease in alpha 1-globulin were observed. However, alpha2-, beta- and gamma 1-globulin, which were not detected in the urine of control rats, were found in substantial amounts in the urine of OOS-Me-treated rats. These findings, coupled with observed increases in urinary glucose levels and consistent specific gravity readings of 1.01 even though treated rats were experiencing oliguria, provide evidence for OOS-Me-induced kidney tubule damage.
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PMID:Dysproteinuria induced in rats by O,O,S-trimethyl phosphorothioate. 359 Feb 28

To determine how useful pulmonary artery catheterization is in abdominal aortic surgery and which patients are most likely to benefit from the procedure, the author studied 28 patients with aneurysms and 22 with obstructive disease. Patients with multiple risk factors, except those with leaking aneurysms, were assessed before operation by pulmonary artery catheterization and volume loading (15 ml of 5% albumin/kg over 12 hours). All patients who underwent operation were assessed and monitored by pulmonary artery catheterization, beginning immediately postoperatively. In 26 patients the procedure made a substantial contribution to assessment or care of their condition, not suggested by the usual clinical and technical modalities. In four patients the proposed surgery was affected; it was cancelled in one, delayed in two and replaced by a lesser procedure in one. Two other patients, thought to have unacceptable cardiac function, were considered suitable for operation after catheterization was done. Eleven patients with suboptimal cardiac index and 2 with volume overload were recognized early after surgery. Two patients with oliguria following repair of a ruptured aneurysm had optimal cardiac indices and renal perfusion assured by pulmonary artery catheterization, which helped to identify unsuspected pulmonary hypertension in three patients, bleeding in one and intestinal infarction in one. Twenty-seven patients were challenged before surgery with 5% albumin and their response was analyzed. In 7 there was no response to the colloid challenge and they suffered much more morbidity than the 20 patients who had a positive hemodynamic response to challenge.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Utility and application of pulmonary artery catheterization in aortic and aortoiliac disease. 373 Sep 69

The fall in serum albumin which occurs after operation can be modified by an intraoperative infusion of 20 g salt-poor human albumin, and the associated fall in colloid osmotic pressure is also corrected. There is a decrease in postoperative oliguria following a colloid infusion but no significant effect has been demonstrated on urinary sodium excretion. Th alteration of fluid and electrolyte metabolism after surgery does not appear to be a direct effect of lowered plasma colloid osmotic pressure. It is suggested that the effect of intraoperative albumin infusion is predominantly haemodynamic.
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PMID:Colloid osmotic pressure and serum albumin following surgery. 706 51

Multiorgan failure (MOF) due to intoxication, trauma or sepsis in the progressive late stages always include acute renal failure (ARF). The prognosis of these patients is poor despite adequate dialysis. This study included 27 consecutive patients (20 men and 7 women, age range 15-77 years) with a rapid progress of MOF including ARF, who were treated by plasma exchange as an attempt to reverse the progress of MOF. Twenty-three of the patients suffered from a septic shock. Oliguria or anuria was present in all, dialysis was performed in 16 of them, and mechanical respiratory aid in 17. Plasma exchange was performed 1-10 times and almost exclusively by centrifuge technique, using albumin and/or liquid stored plasma (in a few cases fresh frozen plasma) as colloidal replacement fluid. Twenty-two patients survived (81%) and 5 patients died. The reasons of death were cerebral haemorrhagia, brain abscess, myocardial sudden death, relapsing sepsis from multiple hepatic abscesses and a not drained psoas abscess. All survivors could leave hospital recovered from renal failure with few other sequelae. The plasma exchange technique is easy to perform despite low blood pressures by using a vein to vein access. Plasma exchange, therefore, may be tried to reverse late stages of multiorgan failure.
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PMID:Plasma exchange in patients with acute renal failure in the course of multiorgan failure. 760 58

An 80-year-old woman with diabetes mellitus was treated with gliclazide. Prior to the gliclazide administration, her urinary excretion of albumin, serum urea nitrogen and serum creatinine were normal. After the medication, oliguria, edema and azotemia developed. On the twenty-fourth day when the edema was severe and generalized, gliclazide administration was terminated. On the following day urinary volume increased suddenly (5,740 ml/day). Polyuria persisted for five days. Edema improved and urea nitrogen and creatinine were normalized thereafter. Though the mechanism is not known, the clinical course suggests that gliclazide is the principal causative factor in the water retention and azotemia in this patient.
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PMID:Possible gliclazide-induced water retention with azotemia. 806 94


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