Diadenosine pentaphosphate modulates glomerular arteriolar tone and glomerular filtration rate

2014 ◽  
Vol 213 (1) ◽  
pp. 285-293 ◽  
Author(s):  
A. Patzak ◽  
M. Carlström ◽  
M. M. Sendeski ◽  
E. Y. Lai ◽  
Z. Z. Liu ◽  
...  
1972 ◽  
Vol 42 (6) ◽  
pp. 711-723 ◽  
Author(s):  
R. Wilkinson ◽  
J. A. Luetscher ◽  
A. J. Dowdy ◽  
C. Gonzales ◽  
G. W. Nokes

1. A group of eight patients with advanced renal failure, and a creatinine clearance of 3·8–24 ml/min, were subjected to sodium loading and sodium depletion. 2. With sodium loading there was a consistent increase in blood pressure (0·01 < P <0·02), an increase in creatinine clearance that was significantly related to changes in mean arterial pressure (r = +0·3, 001 < P < 0·02); an increase in urinary sodium excretion that was closely correlated with changes in creatinine clearance (r = +0·82, P < 0·001); a decrease in fractional reabsorption of filtered sodium that was inversely proportional to creatinine clearance (r = −0·63, 0·05< P < 0·1). 3. Fractional reabsorption of filtered sodium was proportional to creatinine clearance both in the sodium-loaded (r = +0·86, 0·001 < P < 0·01) and sodium-depleted states (r = +0·92, 0·001 < P < 0·01). 4. Urinary aldosterone excretion and plasma renin activity consistently increased with sodium depletion, the percentage increases of the two being significantly related (r = +0·95, P < 0·001). 5. The results suggest that excretion of a sodium load in uraemia may be effected in part as the result of a raised blood pressure that elevates the glomerular filtration rate; by increasing the peritubular capillary pressure this may be responsible for the observed decrease in reabsorption of filtered sodium. The responsiveness of glomerular filtration rate to blood pressure changes suggests a decrease in afferent arteriolar tone that may account for the increased sodium excretion per nephron which occurs even in uraemic patients without hypertension. 6. It is suggested that aldosterone may continue to play an important regulatory role in sodium homeostasis in uraemia and that renin concentrations are the major determinants of aldosterone production in uraemia.


1971 ◽  
Vol 10 (01) ◽  
pp. 16-24
Author(s):  
J. Fog Pedersen ◽  
M. Fog Pedersen ◽  
Paul Madsen

SummaryAn accurate catheter-free technique for clinical determination simultaneouslyof glomerular filtration rate and effective renal plasma flow by means of radioisotopes has been developed. The renal function is estimated by the amount of radioisotopes necessary to maintain a constant concentration in the patient’s blood. The infusion pumps are steered by a feedback system, the pumps being automatically turned on when the radiation measured over the patient’s head falls below a certain preset level and turned off when this level is again readied. 131I-iodopyracet was used for the estimation of effective renal plasma flow and125I-iothalamate estimation of the glomerular filtration rate. These clearances were compared to the conventional bladder clearances and good correlation was found between these two clearance methods (correlation coefficients 0.97 and.90 respectively). The advantages and disadvantages of this new clearance technique are discussed.


2020 ◽  
pp. 44-48
Author(s):  
V. A. Aleksandrov ◽  
L. N. Shilova ◽  
A. V. Aleksandrov

The development of renal dysfunction in patients with rheumatoid arthritis (RA) is due to the presence and severity of autoimmune disorders, chronic systemic inflammation, a multiplicity of comorbid conditions, and pharmacotherapy features. The most important parameter that describes the general condition of the kidneys is glomerular filtration rate (GFR). This review presents the data on the possibilities of modern methods for determining estimated GFR (e-GFR) and the specificity of their use in various clinical situations that accompany the course of RA. For the initial assessment of GFR in patients with RA it is advisable to use the measurement of e-GFR based on serum creatinine concentration using the CKD-EPI equation (2009) (with or without indexing by body surface area). In cases where the e-GFR equations are not reliable enough or the results of this test are insufficient for clinical decision making, the serum cystatin C level should be measured and the combined GFR calculation based on creatinine and cystatin C should be used.


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