PMID: 6170777Sep 1, 1981Paper

Dynamics of glomerular ultrafiltration following open-heart surgery

Kidney International
B D MyersC R Robertson

Abstract

To elucidate how individual determinants might lower the rate of glomerular ultrafiltration (GFR) in some patients following cardiac surgery, we performed hemodynamic measurements and clearance of inulin (as a measure of GFR), PAH (as a measure of effective renal plasma flow [ERPF]), and dextran-40. Two groups of 17 patients each were distinguished by the presence or absence of prerenal azotemia. Glomerular hypofiltration (GFR = 21 +/- 2 vs. 76 +/- 6 ml/min/1.73 m2, P less than 0.001) in the former was accompanied by depressed left ventricular function, arterial pressure, and ERPF (152 +/- 26 vs. 317 +/- 32 ml/min/1.73 m2, P less than 0.001). To determine if factors beside ERPF play a role in lowering GFR, we calculated the efferent oncotic pressure (pie). Failure of GFR to change over a 24-hour period despite increases in ERPF suggested that both patient groups were at filtration pressure disequilibrium (FPD). This condition permits calculation of a unique glomerular ultrafiltration coefficient (Kf). Over a range of pressures for transcapillary hydraulic pressure (deltaP), such that 3 less than or equal to (deltaP - pie) less than or equal to 10 mm Hg (to simulate FPD), Kf was less than 0.08 ml . sec-1 . mm Hg-1 . 1.73 m-2 in ...Continue Reading

References

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Citations

Oct 15, 2008·Clinical Research in Cardiology : Official Journal of the German Cardiac Society·Markus FleschErland Erdmann
Feb 1, 1984·The Journal of Clinical Investigation·B D MyersS Friedman
Oct 17, 2002·Circulation Journal : Official Journal of the Japanese Circulation Society·Nobuhiko HayashidaShigeaki Aoyagi
Mar 24, 2016·Current Transplantation Reports·Colin R LenihanJane C Tan
Feb 14, 1998·Kidney International·R C Blantz
Jul 1, 1985·The Annals of Thoracic Surgery·K FeddersenK Rådegran
Jan 30, 2018·Therapeutic Apheresis and Dialysis : Official Peer-reviewed Journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy·James B DiskinCharles J Diskin
Dec 20, 2014·Journal of the American Society of Nephrology : JASN·Colin R LenihanJane C Tan
Sep 8, 1988·The New England Journal of Medicine·K F Badr, I Ichikawa

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