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

(1)Plasma and urinary levels of methylguanidine, guanidinosuccinic acid and guanidinoacetic acid were measured in normal subjects and in patients with renal failure. (2)Urinary excretion of methylguanidinosuccinic acid was increased in renal failure. Plasma guanidinosuccinic acid concentration was increased and was significantly correlated with the plasma urea concentration. The plasma concentration of methylguanidine was not consistently elevated probably because of an adaptive increase in renal tubular excretion. The excretion of guanidinoacetic acid was decreased in renal failure and plasma concentration remained low. (3) All three guanidines were removed by haemodialysis and their plasma concentrations, although not normal, were much lower in regularly dialysed subjects. (4) Guanidinosuccinic acid and methylguanidine appear to provide alternative pathways for the excretion of nitrogen in patients with renal failure. In advanced uraemia the plasma concentration of methylguanidine and guanidinosuccinic acid may reach levels which have been associated with toxic effects. However, their importance in relation to other uraemic toxins remains difficult to assess.
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PMID:Plasma concentration and urinary excretion of guanidine derivatives in normal subjects and patients with renal failure. 112 56

The experiments we described in this paper demonstrated that the myocardiac lesions without hypertension could be produced by renal failure in rabbits; after this experimental renal failure, increase in blood urea nitrogen and various functional and morphological changes suggestive of heart lesions appeared. The main structural changes in the heart were cellular edema with dilatation of the sarcotubular system, destructive changes of the mitochondria and contractile elements, and coagulative degeneration. These myocardiac lesions are induced by renal failure, and are probably caused by electrolyte imbalance, metabolic disorder, and/or hemodynamic abnormality rather than by hypertensive or toxic factors.
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PMID:Myocardiac changes in experimental renal failure--a light and electron microscopic study. 115 92

The effect of anabolic steroid therapy on anemia in 13 women with and without kidneys undergoing chronic hemodialysis for renal failure was investigated. All but one of the six patients with kidneys demonstrated a noticeable increase in hematocrit level (6.4% to 14.6%). Of the anephric women, four of the seven also showed hematocrit level elevations, but these were less remarkable (3.1% to 6.4%). A majority of patients demonstrated increments in weight and serum creatinine measurements but no definitive alteration in serum blood urea nitrogen levels. The androgenic effects of nandrolone decanoate were minimal and well tolerated. We conclude that anabolic steroid therapy is effective in ameliorating the anemia of women undergoing hemodialysis, if given in a dose that produces minimal and tolerable untoward effects.
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PMID:Response of uremic patients to nandrolone decanoate. 115 56

Fifteen Marine recruits with acute heat stroke were examined for (1) predisposing factors, (2) blood coagulation disturbances, (3) renal function abnormalities, and (4) blood composition alterations. Epidemiologic data identified the following risk factors; previous residence in a temperate climate, first phase of training, fatigue, and strenuous exercise in hot, humid conditions. Results of blood coagulation studies disclosed an increase in prothrombin and partial thromboplastin times, with a decrease in platelet count, probably indicating a transient, low-grade consumptive process. Blood urea nitrogen and creatinine levels and creatinine clearance were normal. Only mild elevations of SGOT, SGPT, and lactic dehydrogenase levels were noted, and in combination with clinical observations, they argued against significant muscle damage. No deaths or instances of renal failure occurred.
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PMID:Acute heat stroke. Epidemiologic, biochemical, renal, and coagulation studies. 124 74

A prospective study of 500 consecutive patients surviving the first 24 hours following cardiac surgical procedures was undertaken to determine the prevalence, etiology and results of therapy for postoperative acute renal failure (ARF). Thirty-five patients developed either moderate or severe ARF and an additional 102 developed mild preprenal azotemia. Positive risk factors noted inthe development of postoperative renal failure included age, elevated preoperative concentrations of blood urea nitrogen (BUN), serum creatinine, and decreased 24 hour urine creatinine clearance. The duration of cardiopulmonary bypass (CPB), aortic cross-clamping, and the total duration of the operation also closely correlated with the incidence of ARF. In the early postoperative period, clinical assessment of hemodynamic change was most helpful in predicting postoperative ARF. Significant negative risk factors included type of operation performed, New York Heart Association classification, the use of preoperative diuretic therapy, and associated other chronic illnesses. During the operation itself, the lowest and mean blood pressures, flow rates on CPB and the presence of hemoglobinuria failed to correlate with subsequent ARF. The mortality rate for established ARF was extremely poor (88.8 per cent), and there were no survivors among those requiring dialysis. ARF following cardiac surgery is a highly lethal complication which arises in a setting of inadequate cardiac function and is associated with a multiple organ system failure. Therapy of this postoperative complication, therefore, appears to be better directed toward its prevention rather than treatment once established.
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PMID:Etiology, incidence, and prognosis of renal failure following cardiac operations. Results of a prospective analysis of 500 consecutive patients. 124 63

Twenty-three patients with blood urea nitrogen (BUN) over 70 and thought clinically to be in renal failure were examined by ultrasound. A correct diagnosis of kidney size and the presence or absence of hydronephrosis or polycystic kidney was made in all but one instance. One kidney in a patient with end-stage renal failure was not seen ultrasonically but was subsequently demonstrated on a retrograde pyelogram. In 10 patients, excretory urography (on 4 occasions with tomography) failed to demonstrate the kidneys adequately. It is suggested that ultrasound should either be the first or second imaging technique in the investigation of patients who present in renal failure of unknown cause.
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PMID:B-scan ultrasound in the evaluation of renal failure. 125 42

Continuous hemodialysis is advantageous for the treatment of renal failure in critically ill patients. This study reports our experience in the treatment of emergencies during chronic renal failure with continuous hemodialysis using a Cuprofane membrane. Eighteen patients with acute decompensations of chronic renal failure were treated with continuous hemodialysis (14 arteriovenous and 4 veno-venous). Procedures lasted a mean of 44.2 h, blood urea nitrogen decreased from 150.3 +/- 49.8 to 60.6 +/- 30.7 mg/dl, metabolic acidosis was corrected raising serum bicarbonate from 10.1 +/- 44 to 17.8 +/- 3.3 mEq/L and hyperkalemia was corrected. Mean ultrafiltration was 239.6 +/- 124.6 ml/h which allowed to withdraw a mean 10.590 ml of ultrafiltrate. Two patients were complicated with femoral artery pseudoaneurysms and one patient with a catheter related sepsis. Global mortality was 16.7%, which compared favorably with the 32.1% predicted mortality according to the Simplified Acute Physiology Score. It is concluded that continuous hemodialysis, a readily available procedure, is suitable for the treatment of emergencies during chronic renal failure.
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PMID:[Continuous hemodialysis in the treatment of chronic renal insufficiency in emergencies]. 134 79

A 62-year-old woman presented with uveitis and abnormal chest X-ray (bilateral hilar adenopathy). Skin biopsy in 1983 had revealed non-caseating epithelioid cell granuloma consistent with sarcoidosis. Her serum biochemical investigations and exploratory laparoscopy suggested nodular liver cirrhosis, but biopsy was not performed. Both blood urea nitrogen (BUN) and serum creatinine values were within normal limits. She received prednisolone therapy of 15 mg daily initially, and later a maintenance dose of 5 mg daily. In 1985, she complained of skin itching and her laboratory data revealed severe renal insufficiency (BUN 97 mg/dl, serum creatinine 12.2 mg/dl) and hypercalcemia (corrected serum calcium level: 11.5 mg/dl). Prednisolone treatment (40 mg daily) resulted in a dramatic improvement of renal function as well as other clinical abnormalities due to sarcoidosis, without any significant changes in liver function. She died of cerebral infarction in 1989. Autopsy showed interstitial nephritis with tubular calcinosis and hyalinized glomeruli. It is postulated that hypercalcemia due to sarcoidosis contributed to the renal failure in this patient. This case suggests that renal damage due to sarcoidosis may be reversible with appropriate corticosteroid therapy.
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PMID:[An autopsy case of sarcoidosis associated with renal failure]. 140 82

The renal effects of pulsatile (pulse pressure 18.0 +/- 1.5 mm Hg [mean +/- SEM]) or nonpulsatile perfusion (mean pulse pressure 1.9 +/- 0.4 mm Hg) during either alpha-stat (mean PaCO2 41.2 +/- 0.9 mm Hg measured at 37 degrees C) or pH-stat (mean PaCO2 60.6 +/- 1.7 mm Hg measured at 37 degrees C) pH management of hypothermic cardiopulmonary bypass (CPB) were studied in 100 patients undergoing elective coronary artery bypass surgery. Mean urine output, fractional excretion of sodium and potassium, and renal failure index all increased during the study period; however, there was no difference among the four different CPB management groups. Mean postoperative creatinine and blood urea nitrogen values decreased compared with preoperative values, again without differences among treatment groups. Three patients developed acute renal insufficiency; of these, two had received nonpulsatile perfusion and pH-stat management, and the other had been managed with pulsatile perfusion and pH-stat management. These three patients all had undergone prolonged CPB and required at least two vasoactive drugs and the use of an intraaortic balloon pump to be weaned from CPB. In patients with normal preoperative renal function undergoing hypothermic CPB, neither the mode of perfusion, pulsatile or nonpulsatile, nor the method of pH management, pH-stat or alpha-stat, influences perioperative renal function.
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PMID:Differences in pH management and pulsatile/nonpulsatile perfusion during cardiopulmonary bypass do not influence renal function. 141 20

Normal histochemical analysis localizes apoA-IV within renal proximal tubules, which suggests that the kidney is a major catabolic site. In clinical renal failure and animal models of decreased renal function, low molecular weight proteins cannot be efficiently filtered through the glomerular basement membrane, and therefore they accumulate in plasma. In normal plasma, apoA-IV exists as both lipoprotein associated and lipoprotein-free, low molecular weight forms. To examine this further, uremic serum apolipoprotein and mRNA levels were examined in surgically 5/6 nephrectomized rats. Compared to sham-operated controls, uremic serum apoA-IV was elevated twofold and was distributed to a greater extent in the lipoprotein-free subfraction. Serum triglycerides were unchanged. Despite finding no correlation between serum apoA-IV and triglyceride levels (in either the d less than 1.006 g/ml or 1.006 less than d less than 1.019 g/ml fraction), serum apoA-IV was positively correlated with the renal function parameters of blood urea nitrogen (r = 0.949, P less than 0.001), creatinine (r = 0.952, P less than 0.001), and uric acid (r = 0.903, P less than 0.001). In addition, the concentration of apoA-IV per milligram of renal homogenate protein in uremic rats was significantly higher than that of control rats, whereas there was no difference in the content of apoA-I between the two groups. ApoA-I, apoA-IV, and apoB mRNA levels in hepatic and in intestinal tissue were undistinguishable between the uremic and surgical sham rats.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Increased serum apoA-IV concentrations in experimental uremic rats. 143 69


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