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Query: UMLS:C0035078 (renal failure)
 31,970 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

20 patients with moderate renal failure (serum creatinine 4.5--12.0 mg/dl) and some uremic symptoms on a diet ad libitum were treated with a high caloric diet containing 0.5--0.7 g/kg/day protein, supplemented with eight essential amino acids and histidine in the form of solution and/or granules. During the treatment uremic symptoms subsided or diminished without the signs of malnutrition, SUN and the ratio SUN/S-creatinine fell and the nitrogen balance and the ratio N-balance/intake N improved. The serum concentration and the urinary excretion of MG and GSA of the 12 patients were determined by Stein's method using the modified Sakaguchi reaction. In all patients, the serum concentration and the urinary excretion of MG and GSA diminished remarkably during the treatment with a low protein diet alone and furthermore with a low protein diet and essential amino acid supply. We concluded that conservative treatment -- low nitrogen diet supplemented with sufficient calories and essential amino acids -- improved the nutritional state of uremic subjects, and decreased the metabolic production of MG and GSA. The results show that the supplementation of essential amino acids to uremic patients may be a useful treatment.
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PMID:Effect of low protein diet and surplus of essential amino acids on the serum concentration and the urinary excretion of methylguanidine and guanidinosuccinic acid in chronic renal failure. 49 26

A 56-year-old Samoan man with a documented history of hypertension, who presented with atrial fibrillation and hypotension, quickly developed renal failure with a serum urea nitrogen of 1.370 g/L and a serum creatinine of 92 mg/L. After hydration of the patient, the creatinine value became normal in two days, the urea nitrogen in four days. The urinary creatinine output during the first 24 h of hospitalization was 3.7 g. This case illustrates the rapidity with which unusually large amounts of creatinine (more commonly seen in chronic renal failure) can accumulate and be excreted in pre-renal failure. It also reaffirms the usefulness of the urea nitrogen/creatnine ratio in evaluating the causes of azotemia.
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PMID:Pre-renal azotemia mimicking chronic renal failure in a hypotensive patient. 49 10

Serial blood samples for determination of drug levels were obtained after intravenous administration of 300 mg of cimetidine. Sixteen patients with varying degrees of renal failure were studied. There was a prolongation of drug half-life in patients with renal insufficiency compared with that in normal controls (P less than 0.001). A significant inverse relationship between the half-life and the creatinine clearance was noted (r= 0.69; P less than 0.01). The effect of hemodialysis was studied in 12 patients. Cimetidine was found to be dialyzable. This was demonstrated both by a shortening of the half-life of the drug during dialysis and by measurement of dialysance. This suggests that the dose schedule should be modified for patients with renal insufficiency and for those on hemodialysis. A single intraveno us dose of cimetidine was well tolerated by the patients. One patient developed an urticarial skin rash, believed to be allergic in nature. There was a transient, mild (but significant) rise in blood urea nitrogen and serum creatinine concentration in 5 patients with moderate renal failure.
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PMID:Effects of renal failure on blood levels of cimetidine. 62 Sep 15

Ten patients have undergone surgical division of the left renal vein (LRV) during operations on the abdominal aorta. Nine were elective procedures performed during the resection of a complicated abdominal aortic aneurysm (six patients) or treatment of complete infrarenal aortic occlusion (three patients). The first patient in this series underwent emergency LRV ligation at the renal hilum for the control of hemorrhage incurred during an elective aneurysmectomy. This patient survived postoperative renal failure and myocardial infarction, but died 21 months later from another myocardial infarction. At the time of death, he had moderate renal insufficiency. None of the remaining nine patients undergoing elective LRV division experienced any apparent renal dysfunction, as measured by urine sediment, serum creatinine, blood urea nitrogen, and intravenous pyelography. Although not recommended as a routine maneuver, division of the LRV is advocated as a safe adjunct for surgical exposure in difficult aortic procedures.
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PMID:Division of the left renal vein: a safe surgical adjunct. 62 89

A rat model was utilized to compare the nephrotoxic potential of gentamicin and tobramycin. Gentamicin, 40 mg/kg per day, predictably produced renal failure and morphological evidence of proximal tubular necrosis over 14 days of treatment. An identical dosage of tobramycin was associated with only minimal morphological changes and normal concentrations of serum creatinine and blood urea nitrogen. Similar results were obtained even after the tobramycin dosage was tripled to 120 mg/kg per day. A decrease in urine osmolality, mechanism unknown, was observed in all aminoglycoside-treated rats, but the lowest osmolalities were found in the gentamicin-treated rats. According to both histological criteria and renal function measurements, gentamicin was more nephrotoxic than tobramycin in this animal model.
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PMID:Comparative nephrotoxicity of gentamicin and tobramycin in rats. 62 89

A prospective analysis of the value of urinary diagnostic indices in ascertaining the cause of acute renal failure was undertaken. Our results show that in the setting of acute oliguria a diagnosis of potentially reversible prerenal azotemia is likely with urine osmolality greater than 500 mosm/kg H2O, urine sodium concentration less than 20 meq/litre, urine/plasma urea nitrogen ratio greater than 8, and urine/plasma creatinine ratio greater than 40. Conversely, a urine osmolality less than 350 mosm/kg, urine sodium concentration greater than 40 meq/liter, urine/plasma urea nitrogen ratio less than 3, and urine/plasma creatinine ratio less than 20 suggest acute tubular necrosis. A significant number of oliguric patients will not have urinary indices that fall within these guidelines. In this setting, urine sodium concentration divided by the urine-to-plasma creatinine ratio (the renal failure index) and the fractional excretion of filtered sodium provide a reliable means of differentiating reversible prerenal azotemia from acute tubular necrosis.
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PMID:Urinary diagnostic indices in acute renal failure: a prospective study. 66 84

The amount of urea nitrogen released and the amount reincorporated into albumin has been measured in healthy and uremic individuals on both normal and low-protein diets. The albumin synthesis rate was measured simultaneously. Gut urea breakdown was only 50% higher in renal failure than in health, but the efficiency of utilization of the nitrogen thus released was increased more than 6-fold in renal failure and was higher on a low protein than on a normal protein diet. The lower the albumin synthetic rate, the greater was the efficiency of incorporation of urea nitrogen into albumin. The rate of urea nitrogen incorporation into albumin increased on average 14-fold in chronic renal failure. The absolute rate of utilization (84 mumole/hr) was, however, small and comprised on average only 2.4% of the nitrogen used in albumin synthesis. These findings suggest that although some urea derived nitrogen is incorporated into albumin, the amount is not nutritionally significant even under conditions of protein deprivation and high urea availability.
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PMID:Anabolic role of urea in renal failure. 68 76

Serum and urine fibrin(ogen) degradation products (FDP), FDP clearances, and serum urea nitrogen (SUN) concentrations of rats challenged with glycerol-induced myohemoglobinuria were measured serially over a period of 4 days. The results obtained in animals that developed acute renal failure (ARF) were compared with those obtained in rats made refractory to renal failure by long-term salt loading or recent recovery from prior renal failure. Only the rats susceptible to ARF experienced a major rise in serum FDP concentration. Urine FDP excretion rose most markedly in the same rats but, being elevated in all groups. showed the utilization of fibrinogen whether serum FDP values increased or not. The results obtained might reflect differences in the degree of intravascular coagulation which are pathogenetically important. It is possible, however, that increased serum FDP concentrations found exclusively in rats with ARF are the results rather than the cause of impaired filtration, and that reduced tubular absorption may at least partly account for the high urinary FDP excretion observed in this model of experimental acute renal failure.
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PMID:The pathogenetic significance of intravascular coagulation in experimental acute renal failure. 74 Jan 11

The catabolic reaction to operation or severe trauma will give rise to a real risk of starvation unless sufficient attention is paid to the patient's energy and nitrogen requirements as well as to his fluid and electrolyte balance. The indications for intravenous nutrition in such cases are outlined and the various preparations available for the supply of energy and nitrogen are detailed. In the planning of an intravenous feeding regimen the patient's daily nitrogen losses must be estimated and a formula is provided for this purpose. The technique of parenteral nutrition is discussed and attention drawn to the various metabolic and complications that may be encountered. Neither hepatic impairment nor renal failure need be regarded as a contra-indication to intravenous feeding.
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PMID:Intravenous nutrition. Why, when, and with what? 80 91

Parenteral 1.75 per cent L-essential amino acids in 47 per cent dextrose (Group I 11 patients) or 47 per cent dextrose (Group II, 9 patients) were administered to patients with severe acute renal failure in a single blind-controlled study. Survival rates (55 per cent in Group I and 56 per cent in Group II) and duration of renal failure were similar in the two groups. Rate of daily rise in blood urea nitrogen was significantly reduced during intravenous nutrition in Group I but not in Group II. Serious complications of intravenous nutrition did not occur. Since improved nitrogen metabolism is demonstrated, further trials of essential amino acid therapy in acute renal failure are indicated.
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PMID:Parenteral essential amino acids in acute renal failure. 80 7


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