scholarly journals A short-term antihypertensive treatment-induced fall in glomerular filtration rate predicts long-term stability of renal function

1997 ◽  
Vol 51 (3) ◽  
pp. 793-797 ◽  
Author(s):  
Alfred J. Apperloo ◽  
Dick de Zeeuw ◽  
Paul E. de Jong
Keyword(s):  
Renal Function ◽  
Glomerular Filtration Rate ◽  
Glomerular Filtration ◽  
Antihypertensive Treatment ◽  
Filtration Rate ◽  
Short Term ◽  
Term Stability ◽  
Long Term Stability

scholarly journals Long-term renal function and continence status in patients with

2013 ◽  
Vol 1 (4) ◽  
pp. 371 ◽  
Author(s):  
Luis H.P. Braga ◽  
Armando J. Lorenzo ◽  
Sumit Dave ◽  
Maria H. Del-Valle ◽  
Antoine E. Khoury ◽  
...  
Keyword(s):  
Renal Function ◽  
Glomerular Filtration Rate ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
Urogenital Sinus ◽  
Renal Outcome ◽  
Urinary Continence ◽  
Renal Ultrasound ◽  
Common Channel

Introduction: Urinary continence after cloacal repair is difficult to achieveand renal outcome in patients with cloacal malformations has been scarcelyreported. As a result, we reviewed our experience with cloacal malformationsto determine the status of continence and the long-term renal function in thesechildren.Methods: A retrospective chart review from 1990 to 2003 identified 12 patientswith cloacal malformation (1 posterior, 4 complex and 7 classical) who underwentsurgical reconstruction. The confluence was defined as high (commonchannel ≥ 3 cm) and low (< 3 cm) by cystovaginoscopy. Renal ultrasound,voiding cystouretrogram, renal scan and sacral radiograph were performedin all children. Most patients underwent 1-stage abdominoperineal pull-through,applying the principle of total urogenital sinus mobilization. We collected dataregarding hydronephrosis, vesicoureteral reflux and split differential renal function.Renal outcome was evaluated based on glomerular filtration rate and ageadjustedserum creatinine values (μmol/L). Urinary continence was definedas a dry interval > 4 hours.Results: Patients’ mean age at surgery was 20 months (range 7–29 mo). Ofthe 12 children who underwent cloacal repair, 7 (58.3%) had a common channel≥ 3cm. Renal anomalies were identified in 3 of 12 (25%) girls: there were 2 solitary kidneys and 1 pelvic kidney. Lumbar–sacral radiography demonstrated bony abnormalities in 11 of the 12 (91.6%) cases: hemivertebra in 3 cases, sacral agenesis in 4 cases, hypoplastic sacrum in 3 cases and bifid sacrum in 1 case. Total urogenital sinus mobilization through an abdominoperineal approach in a single stage was performed in 8 girls. Follow-up ranged from 4 to 14 years (mean 8.5 yr). Eight (66.6%) children had dry intervals > 4 hours, 5 (62.5%) of them were on clean intermittent catheterization through aMitrofanoff channel and 1 (12.5%) was through the urethra. The remaining 2 (25%) patients were voiding spontaneously. Three (33.3%) patients were totally incontinent, and 1 (8.3%) patient was awaiting reconstruction. The mean measured glomerular filtration rate was 93.5 mL/min/1.73m2 (range 34–152 mL/min/1.73m2). Four (57.1%) of 7 patients who had a common channel ≥ 3 cm ended up needing augmentation cystoplasty, compared with none of the patients with a common channel < 3 cm (57.1% v. 0%, p = 0.038).Conclusion: Urinary continence can be achieved in most patients with cloacalmalformation at the expense of major reconstructive surgery and despite thepresence of associated urological abnormalities. However, these childrenharbour an important risk for renal impairment later in life and should be closelymonitored.

scholarly journals Changes in glomerular filtration rate in liver recipients after reduced exposure to calcineurin inhibitors with concomitant everolimus administration within the first year after immunosuppression conversion

2021 ◽  
Vol 23 (4) ◽  
pp. 32-41
Author(s):  
V. E. Syutkin ◽  
A. A. Salienko ◽  
S. V. Zhuravel ◽  
M. S. Novruzbekov
Keyword(s):  
Renal Function ◽  
Glomerular Filtration Rate ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
Calcineurin Inhibitors ◽  
Deceased Donor ◽  
First Year ◽  
The Mean ◽  
Older Recipients

Objective: to compare changes in estimated glomerular filtration rate (eGFR) in liver recipients with initially normal and impaired eGFR within the first year after immunosuppression conversion.Materials and methods. Enrolled in the study were 215 recipients of deceased-donor livers from February 2009 to February 2020, who received everolimus with dose reduction or complete withdrawal of calcineurin inhibitors (immunosuppression conversion, ISxC) for varying periods of time. GFR was measured using the MDRD-4 formula immediately before ISxC, then 3, 6, and 12 months after orthotopic liver transplantation (LTx). One month was considered an acceptable temporary deviation from the corresponding point.Results. At the time of ISxC, 32 (15%) of 215 recipients had normal renal function. Chronic kidney disease (CKD) increased in 60% of the recipients with normal eGFR by the end of the first year following ISxC; the fall in eGFR was particularly pronounced in older recipients. In the group with a baseline eGFR of 60–89 mL/min/1.73 m2, eGFR normalized in 62% of cases within 12 months; 28% of cases had no changes in renal function. In the subgroup with a pronounced decrease in eGFR at the time of ISxC, increased eGFR was observed as early as 1 month after ISxC, and the maximum was recorded after 3–6 months. The mean eGFR relative to baseline by month 3 after eGFR were higher for ISxC that was done in the first 2 months after LTx (19.7 ± 15.7 ml/minute/1.73 m2) than for ISxC done in the long-term period after LTx (10.1 ± 8.7 ml/minute/1.73 m2, p < 0.05).Conclusion. Changes in eGFR in liver recipients receiving EVR plus low-dose calcineurin inhibitor (CNI) depend on baseline eGFR and are multidirectional. The use of ISxC in the early post-LTx period led to a more pronounced improvement in eGFR. Maximal changes in eGFR were observed by 3–6 months after ISxC.

scholarly journals Effect of cyclosporin and tacrolimus on kidney function in liver recipients

2018 ◽  
Vol 4 (3) ◽  
pp. 37-42
Author(s):  
Elena Kosmacheva ◽  
Anna Babich
Keyword(s):  
Chronic Kidney Disease ◽  
Liver Transplantation ◽  
Renal Function ◽  
Glomerular Filtration Rate ◽  
Kidney Disease ◽  
Glomerular Filtration ◽  
Kidney Function ◽  
Filtration Rate ◽  
Calcineurin Inhibitors

Introduction. Chronic renal failure is a significant issue regarding treatment of patients after liver transplantation. One of the factors determining the impaired renal function after liver transplantation is a long-term immunosuppressive therapy based on calcineurin inhibitors. The objective of the study was to evaluate the dynamics of renal function, depending on the use of various calcineurin inhibitors in the long-term postoperative period in liver recipients in real clinical practice. Materials and methods. A retrospective analysis of the renal function in patients operated in the State Public Health Budget Institution “Scientific Research Institute – S.V. Ochapovsky Regional Clinic Hospital № 1”, Krasnodar Region, was carried out. This article describes dynamics of creatinine level and glomerular filtration rate (GFR) in patients before liver transplant, as well as 6 months, 1, 2 and 3 years after surgery. GFR was calculated using the CKD-EPI formula (Chronic Kidney Disease Epidemiology Collaboration). Statistical processing of the results was carried out using the Statistica 10 software package. Results and discussion. Before transplantation, the level of creatinine in the blood plasma was 82.9±19.8 mmol/l, 6 months later a20.4% increase in creatinine was registered (p=0.004), 12, 24 and 36 months later – it increased by 24.8% (p=0.00001), 24.4% (p=0.0004), and 26.0% (p=0.0005), respectively. Both cyclosporine and tacrolimus caused an increase in the level of creatinine. Baseline GFR was 83.4±25.9, the reduction in GFR occurred in comparison with the baseline by 14.2% (p=0.0005), 18.8% (p=0.00001), 20.2% (p=0.00003), 22.6% % (p=0.00006) 6, 12, 24 and 36 months later, respectively. The degree of the decrease in GFR against the background of tacrolimus therapy did not differ significantly from that in case of cyclosporine. Verification of chronic kidney disease and the administration of statins were recorded in isolated cases. Conclusions. In liver recipients, the level of creatinine rises and GFR decreases. Reduction of kidney function occurs against the background of both inhibitors of calcineurin, in connection with which it is necessary to increase the doctors’ alertness for early detection of a decrease in glomerular filtration rate with further verification of chronic kidney disease.

Glomerular Filtration Rate After Alpha-Radioimmunotherapy with 211At-MX35-F(ab′)2: A Long-Term Study of Renal Function in Nude Mice

2009 ◽  
Vol 24 (6) ◽  
pp. 649-658 ◽  
Author(s):  
Tom Bäck ◽  
Börje Haraldsson ◽  
Ragnar Hultborn ◽  
Holger Jensen ◽  
Martin E. Johansson ◽  
...  
Keyword(s):  
Renal Function ◽  
Glomerular Filtration Rate ◽  
Glomerular Filtration ◽  
Nude Mice ◽  
Filtration Rate ◽  
Term Study ◽  
Long Term Study

scholarly journals Initial Estimated Glomerular Filtration Rate Decline and Long-Term Renal Function During Intensive Antihypertensive Therapy

Hypertension ◽  
2020 ◽  
Vol 75 (5) ◽  
pp. 1205-1212 ◽  
Author(s):  
Didier Collard ◽  
Tom F. Brouwer ◽  
Rik H.G. Olde Engberink ◽  
Aeilko H. Zwinderman ◽  
Liffert Vogt ◽  
...  
Keyword(s):  
Renal Function ◽  
Glomerular Filtration Rate ◽  
Glomerular Filtration ◽  
Antihypertensive Therapy ◽  
Filtration Rate ◽  
Estimated Glomerular Filtration Rate ◽  
Glomerular Filtration Rate Decline

scholarly journals Cardiorenal Effects of Long‐Term Phosphodiesterase V Inhibition in Pre–Heart Failure

2022 ◽  
Author(s):  
Scott A. Hubers ◽  
Siu‐Hin Wan ◽  
Fadi W. Adel ◽  
Sherry L. Benike ◽  
John C. Burnett ◽  
...  
Keyword(s):  
Heart Failure ◽  
Glomerular Filtration Rate ◽  
Glomerular Filtration ◽  
Renal Clearance ◽  
Filtration Rate ◽  
Urinary Sodium ◽  
Short Term ◽  
Renal Response ◽  
Clearance Study

Background Phosphodiesterase V (PDEV) is upregulated in heart failure, leading to increased degradation of cGMP and impaired natriuresis. PDEV inhibition improves the renal response to B‐type natriuretic peptide in animal models. We tested the hypothesis that long‐term PDEV inhibition would improve renal function and cardiorenal response after short‐term volume load in subjects with pre–heart failure. Methods and Results A total of 20 subjects with pre–heart failure (defined as an ejection fraction ≤45% without previous diagnosis of heart failure) and renal impairment were randomized in a 2:1 manner to tadalafil or placebo. Baseline echocardiography and renal clearance study were performed, followed by a short‐term saline load and repeated echocardiography and renal clearance study. Subjects then received either tadalafil at a goal dose of 20 mg daily or placebo, and the study day was repeated after 12 weeks. Long‐term tadalafil did not improve glomerular filtration rate (median increase of 2.0 mL/min in the tadalafil group versus 13.5 mL/min in the placebo group; P =0.54). There was no difference in urinary sodium or cGMP excretion with PDEV inhibition following short‐term saline loading. Conclusions Glomerular filtration rate and urinary sodium/cGMP excretion were not significantly different after 12 weeks of tadalafil compared with placebo. These results do not support the use of PDEV inhibition to improve renal response in patients with pre–heart failure. Registration URL: https://www.clinicaltrials.gov ; Unique identifier: NCT01970176.

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