Hypertension and renal dysfunction in primary hyperparathyroidism: effect of parathyroidectomy

1989 ◽  
Vol 76 (3) ◽  
pp. 289-296 ◽  
Author(s):  
A. K. Salahudeen ◽  
T. H. Thomas ◽  
L. Sellars ◽  
S. Tapster ◽  
P. Keavey ◽  
...  
Keyword(s):  
Glomerular Filtration Rate ◽  
Essential Hypertension ◽  
Primary Hyperparathyroidism ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
Plasma Renin ◽  
Whole Body ◽  
Before And After ◽  
51Cr Edta ◽  
Normotensive Control

1. Twenty-four patients with primary hyperparathyroidism were studied before and 18 restudied 6.5 months (mean) after parathyroidectomy, to investigate the pathogenesis of the hypertension which may accompany this condition. Comparison was made with age-matched patients with essential hypertension and with normotensive control subjects. 2. There was a significant inverse relationship between mean arterial pressure and 51Cr-labelled ethylenediaminetetra-acetate (51Cr-EDTA) clearance in patients with hyperparathyroidism both before and after parathyroidectomy, but not in patients with essential hypertension. 3. Creatinine clearance appeared to overestimate glomerular filtration rate in some patients with hyperparathyroidism, falling significantly after surgery while 51Cr-EDTA clearance was unchanged. This observation may explain the failure of some previous studies to relate hypertension to impairment of renal function. 4. Plasma renin activity, plasma aldosterone and whole-body exchangeable sodium did not differ between normotensive and hypertensive patients with primary hyperparathyroidism and were unchanged after surgery. 5. Parathyroidectomy did not result in any change in blood pressure or in glomerular filtration rate measured by 51Cr-EDTA clearance.

Studies on the Mechanism of Hypernatriuresis in Essential Hypertension in Relation to Measurements of Plasma Renin Concentration, Body Fluid Compartments and Renal Function

1971 ◽  
Vol 41 (3) ◽  
pp. 219-231 ◽  
Author(s):  
M. A. D. H. Schalekamp ◽  
X. H. Krauss ◽  
M. P. A. Schalekamp-Kuyken ◽  
G. Kolsters ◽  
W. H. Birkenhäger
Keyword(s):  
Cardiac Output ◽  
Glomerular Filtration Rate ◽  
Essential Hypertension ◽  
Arterial Pressure ◽  
Glomerular Filtration ◽  
Sodium Excretion ◽  
Filtration Rate ◽  
Plasma Renin ◽  
Plasma Renin Concentration ◽  
Intrarenal Pressure

1. In twenty-two patients representing different stages of benign essential hypertension, hyperosmotic saline was administered intravenously. Determinations of intra-arterial pressure, renal plasma flow, glomerular filtration rate and plasma renin concentration were carried out before and, in the majority, also during and after saline infusion. Changes in cardiac output were followed in ten patients. Plasma volume and extracellular volume were determined in the control period only, although haemodilution was assessed by haematocrit readings. 2. Excess of sodium excretion showed a wide range and was related to the patient's age, as well as to a set of parameters reflecting intrarenal pressure patterns; hypernatriuresis consistently occurred in older patients, in whom renal vascular resistance and nitration fraction were elevated and plasma renin was suppressed. It could not be clarified whether hypernatriuresis together with renin suppression were determined by intrarenal pressure relationships or by an independent age-related factor in the hypertensive patient. 3. Excess of sodium excretion was not related to increments in arterial pressure, cardiac output, renal blood flow or glomerular filtration rate. 4. Plasma renin concentration failed to show consistent changes after hyperosmotic saline infusion. 5. It is concluded that natriuresis is not mediated by changes in the activity of the renin-angiotensin system. Hypernatriuresis appears to be a feature of progressive benign hypertension.

Indexed glomerular filtration rate as a function of age and body size

2000 ◽  
Vol 98 (4) ◽  
pp. 439-444 ◽  
Author(s):  
A. M. PETERS ◽  
B. L. HENDERSON ◽  
D. LUI
Keyword(s):  
Body Weight ◽  
Glomerular Filtration Rate ◽  
Glomerular Filtration ◽  
Linear Function ◽  
Filtration Rate ◽  
Whole Body ◽  
Inverse Association ◽  
Single Compartment ◽  
Wide Range ◽  
51Cr Edta

The conventional way in which to scale or index a measurement of glomerular filtration rate (GFR) is to express it in relation to body surface area (BSA). However, BSA may not be appropriate for infants and children because, as individuals increase in size, their relative BSA decreases. Several other whole-body variables have been suggested as alternatives, including extracellular fluid volume (vECF). The purpose of the present study was to compare BSA and vECF as variables against which to index GFR, and in particular to look at this comparison in children versus adults. A total of 130 patients (age range 1–80 years; 40 patients < 12 years) undergoing clinically indicated routine measurement of GFR using the bolus-injection single-compartment technique were included in the study. GFR was measured as the plasma clearance of [51Cr]EDTA as assessed from three peripheral venous blood samples taken between 2 and 4 h after injection of [51Cr]EDTA. Volume of distribution (Vd) was obtained by extrapolation of the clearance curve to zero time. GFR was scaled to a BSA of 1.73 m2. GFR and GFR/1.73 m2 were corrected to account for the assumption of a single compartment. The rate constant of the exponential between 2 and 4 h was also corrected to give GFR/litre ECF. GFR and GFR/1.73 m2 were both divided by GFR/litre ECF, to give vECF and vECF/1.73 m2 respectively. Weight per unit BSA increases as a linear function of BSA. vECF is always less than Vd, on average by about 30%. vECF increased as an exponential function of BSA and as a linear function of body weight. vECF/70 kg body weight was higher in children (16.2±3 litres) than adults (13.4±2.3 litres), but vECF/1.73 m2 was lower in children (9.7±1.7 litres) compared with adults (12.4±2 litres). vECV/1.73 m2 increased as a function of both age and BSA, but vECF/kg decreased. GFR/12.5 litres vECF was higher than GFR/1.73 m2 in children, but these values were similar in adults, with the ratio of these two forms of indexed GFR falling significantly with both age and BSA. Although this was not a normal population, but one with a wide range of renal function, GFR/vECF showed a strong inverse association with age, whereas for GFR/BSA the association was weak. In conclusion, these data provide further evidence that vECF is more valid physiologically for indexing GFR than is BSA, especially in children. Nevertheless, a GFR measurement in a child should ideally be expressed as a percentage of normal for that child's age. However, such normal values are not yet available.

Global REACH 2018: Volume regulation in high-altitude Andeans with and without chronic mountain sickness

2021 ◽  
Author(s):  
Andrew R. Steele ◽  
Michael M. Tymko ◽  
Victoria L. Meah ◽  
Lydia L Simpson ◽  
Christopher Gasho ◽  
...  
Keyword(s):  
Glomerular Filtration Rate ◽  
Plasma Renin Activity ◽  
High Altitude ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
Plasma Renin ◽  
Renin Activity ◽  
Chronic Mountain Sickness ◽  
Plasma Aldosterone Concentration ◽  
Mountain Sickness

The high-altitude maladaptation syndrome known as chronic mountain sickness (CMS) is characterized by polycythemia and is associated with proteinuria despite unaltered glomerular filtration rate. However, it remains unclear if indigenous highlanders with CMS have altered volume regulatory hormones. We assessed N-terminal pro-B-type natriuretic peptide (NT pro-BNP), plasma aldosterone concentration, plasma renin activity, kidney function (urinary microalbumin, glomerular filtration rate), blood volume, and estimated pulmonary artery systolic pressure (ePASP), in Andean males without (n=14; age=39±11) and with (n=10; age=40±12) CMS at 4330 meters (Cerro de Pasco, Peru). Plasma renin activity (non-CMS: 15.8±7.9 vs. CMS: 8.7±5.4 ng/ml; p=0.025) and plasma aldosterone concentration (non-CMS: 77.5±35.5 vs. CMS: 54.2±28.9 pg/ml; p=0.018) were lower in highlanders with CMS compared to non-CMS, while NT pro-BNP was not different between groups (non-CMS: 1394.9±214.3 vs. CMS: 1451.1±327.8 pg/ml; p=0.15). Highlanders had similar total blood volume (non-CMS: 90±15 vs. CMS: 103±18 ml • kg-1; p=0.071), but Andeans with CMS had greater total red blood cell volume (non-CMS: 46±10 vs. CMS 66±14 ml • kg-1; p<0.01) and smaller plasma volume (non-CMS 43±7 vs. CMS 35±5 ml • kg-1; p=0.03) compared to non-CMS. There were no differences in ePASP between groups (non-CMS 32±9 vs. CMS 31±8 mmHg; p=0.6). A negative correlation was found between plasma renin activity and glomerular filtration rate in both groups (group: r=-0.66; p<0.01; non-CMS: r=-0.60; p=0.022; CMS: r=-0.63; p=0.049). A smaller plasma volume in Andeans with CMS may indicate an additional CMS maladaptation to high-altitude, causing potentially greater polycythemia and clinical symptoms.

Evolution of glomerular filtration rate in patients with essential hypertension: impact of type 2 diabetes

2014 ◽  
Vol 8 (4) ◽  
pp. e101
Author(s):  
Julian Segura ◽  
Cesar Cerezo ◽  
Enrique Morales ◽  
Luisa Fernandez ◽  
Lucia Guerrero ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Glomerular Filtration Rate ◽  
Essential Hypertension ◽  
Glomerular Filtration ◽  
Filtration Rate

scholarly journals Influence of the background activity region selection on the measurement of glomerular filtration rate using the Gates method

2008 ◽  
Vol 65 (10) ◽  
pp. 729-732 ◽  
Author(s):  
Marija Dopudja ◽  
Boris Ajdinovic ◽  
Ljiljana Jaukovic ◽  
Marijana Petrovic ◽  
Zoran Jankovic
Keyword(s):  
Glomerular Filtration Rate ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
Background Activity ◽  
Accurate Method ◽  
Lateral Side ◽  
Lower Pole ◽  
Region Selection ◽  
Significant Difference ◽  
51Cr Edta

Background/Aim. The most frequent method for the assessment of glomerular filtration rate GFR) in clinical practice is clearance of creatinine, clearance of chromium-51 radiolabelled ethylene diamine tetraacetic acid (51Cr-EDTA) and clearance of technetium-99m radiolabelled diethylene triamine pentaacetic acid (99mTc-DTPA). The Gates method for glomerular filtration rate assessment is based on distribution of 99mTc-DTPA in the kidney 2-3 minute after its applying. Calculation of GFR is corrected for the background and depth of the kidney and finally expressed as a percentage of the net injected counts. This value of GFR highly correlates with biexponential model as the most accurate method for the assessment of GFR. The aim of this study was to determine the influence of different background sites on GFR rate assessment using the Gates method. Methods. We analysed 50 patients who were divided into two groups: the group of healthy subjects (21 subjects, mean age 47.38 yrs) and the group of subjects with unilateral kidney damage (29 subjects, mean age 39.79 yrs). Three different background activity regions were chosen: a region drawn below the lower pole of each kidney, region drawn by the lateral side of each kidney and region drawn around the whole kidney. Results. Gromerular filtration rate calculated by the use of a region under the lower pole is statistically significantly higher than GFR calculated using a region by the lateral side and around the whole kidney (p < 0.0001). Glomerular filtration rate calculated using the region by the lateral side and region around the whole kidney did not show statistically significant difference (p > 0.05). Conclusion. The selection of background activity region has a significant influence on GFR rate measured by the Gates method. It is recommended to use only one method for choosing the region of background activity.

scholarly journals Influence of Early Bladder Imaging in Experimental Rabbits on the Quantitative Determination of Glomerular Filtration Rate by the Gates Method

2020 ◽  
Vol 2020 ◽  
pp. 1-13
Author(s):  
Changyin Wang ◽  
Shun Li ◽  
Chun Gao ◽  
Wasili Maimaiti ◽  
Qisheng Yang ◽  
...  
Keyword(s):  
Glomerular Filtration Rate ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
Load Test ◽  
Renal Uptake ◽  
Quantitative Calculation ◽  
Uptake Rates ◽  
Before And After ◽  
Baseline Status ◽  
The Difference

Objective. To investigate the influence of early bladder imaging (EBI) in experimental rabbits on the quantitative calculation of glomerular filtration rate (GFR) by the Gates method. Methods. We retrospectively analyzed the data of dynamic renal scintigraphy (DRS) in experimental rabbits. We calculated renal uptake during minutes 1-2 and 2-3 by correcting bladder radioactivity and computed the split GFR by renal uptake. Then, the EBI and GFR between 1-2 min and 2-3 min were compared, respectively. Results. The EBI proportion (57.3%) at 2-3 min of DRS was higher than that (8.5%) at 1-2 min ( P < 0.05 ). The correlations between the 1-2 min and 2-3 min uptake rates of unobstructed kidneys after correction ( r = 0.952 ‐ 0.979 ) were higher than those before correction ( r = 0.859 ‐ 0.936 ). However, the correlation between the two in obstructed kidneys was not improved ( r before = 0.967 versus r after = 0.968 ). For unobstructed kidneys, the difference in GFR based on 2-3 min uptake between before and after correction was significant ( P < 0.05 ), but not in obstructed kidneys ( P > 0.05 ). For GFR based on 1-2 min uptake, the difference between before and after correction was not significant in obstructed or unobstructed kidneys ( P > 0.05 ). Before correction, the GFR of unobstructed kidneys of 10.5% of the rabbits in the protein load test was lower than that in the baseline status, but not so after correction. Conclusion. The 2-3 min EBI on DRS has a significant influence on the GFR calculated by the Gates method in experimental rabbits. Controlling water intake or calculating the GFR by 1-2 min renal uptake helps to avoid the influence of EBI on GFR.

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