PMID: 6164815Oct 1, 1980Paper

Pathophysiology of hemodynamically mediated acute renal failure in man

Kidney International
B D MyersA S Michaels

Abstract

A tubular injury characterized by intraluminal obstruction and transtubular backleak of glomerular filtrate occurs in experimental acute renal failure (ARF) in animals. To determine whether these alterations also occur in human ARF, we studied 44 patients developing nonoliguric ARF following cardiac surgery. The delay in appearance of i.v. administered inulin in urine (Tu) was used as a measure of tubular fluid flow rate. Tu was not longer in 13 ARF patients than it was in control subjects (7.2 vs 9.0 min), suggesting that at least a subpopulation of tubules was widely patent. The fractional urinary dextran clearance profile (thetaD; radii, 20 to 40 A) was then determined in 20 patients with sustained ARF in whom inulin clearance averaged 11 +/- 1 ml/min/1.73 m2. A mass conservation model, which assumes that thetaD in Bowman's space in ARF is the same as that measured in controls, when applied to the experimental observations revealed that, on the average, 42% of filtered inulin was lost by transtubular backleak. A similar fractional inulin backleak (38%) persisted in 11 additional patients in whom ARF had begun to recover and in whom inulin clearance averaged 26 +/- 3 ml/min/1.73 m2. These findings suggest that in hemodynamica...Continue Reading

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Citations

Aug 1, 1982·Klinische Wochenschrift·H von GiseE Mickeler
May 1, 1990·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·R J Byrick, D K Rose
Nov 30, 2000·Anesthesiology Clinics of North America·M Hladunewich, M H Rosenthal
Jan 9, 1986·The New England Journal of Medicine·B D Myers, S M Moran
Jun 5, 1986·The New England Journal of Medicine·A Bidani, P Churchill
Feb 1, 1984·The Journal of Clinical Investigation·B D MyersS Friedman
Oct 1, 1985·The Journal of Clinical Investigation·S M Moran, B D Myers
May 29, 1998·The Journal of Clinical Investigation·O KwonB D Myers
Aug 1, 1992·The American Journal of the Medical Sciences·S R Hays
Sep 1, 1981·Kidney International·B D MyersC R Robertson
Jun 1, 1985·Kidney International·S M Moran, B D Myers
Mar 9, 2005·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Mark Stafford-SmithUNKNOWN Perioperative Genetics and Safety Outcomes Study (PEGASUS) Investigative Team
Jul 5, 2006·The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation·Shona S PendseAnil Chandraker
Jan 1, 1981·Clinical and Experimental Dialysis and Apheresis·D G BichetR W Schrier
Apr 1, 1984·The American Journal of Medicine·D E Oken
Mar 1, 1997·Palliative Medicine·A D Macleod, L E Whitehead
Jan 1, 1994·European Archives of Psychiatry and Clinical Neuroscience·H J KoponenP J Riekkinen
Jan 1, 1994·European Archives of Psychiatry and Clinical Neuroscience·H J KoponenE Leinonen
Feb 1, 1993·Psychological Medicine·H J Koponen, P J Riekkinen
Nov 1, 1992·Psychological Medicine·I G McKeithE K Perry
Jan 1, 1990·Journal of General Internal Medicine·J Francis, W N Kapoor
Aug 1, 1989·Psychological Medicine·H KoponenP J Riekkinen
Oct 1, 1993·Integrative Physiological and Behavioral Science : the Official Journal of the Pavlovian Society·J S Howard
Nov 1, 1981·The British Journal of Psychiatry : the Journal of Mental Science·G E Berrios
Jan 5, 2012·Psychiatry Investigation·Nina KhachiyantsKye Y Kim
May 28, 2015·CA: a Cancer Journal for Clinicians·Reema D Mehta, Andrew J Roth
Jan 14, 2005·The International Journal of Artificial Organs·S M Jakob
Feb 1, 1991·DICP : the Annals of Pharmacotherapy·S Robert, B J Zarowitz
Apr 1, 1982·The American Journal of Medicine·B D MyersR L Jamison

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