• 제목/요약/키워드: Augmented renal clearance

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Augmented renal clearance

  • Atkinson, Arthur J. Jr.
    • Translational and Clinical Pharmacology
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    • 제26권3호
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    • pp.111-114
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    • 2018
  • Adding to the complexity of caring for critically ill patients is the fact that many of them have a creatinine clearance that exceeds $130mL/min/1.73m^2$. This phenomenon, termed augmented renal clearance (ARC), has only recently been widely recognized and its pathogenesis remains incompletely understood. However, ARC has been shown to result in increased dose requirements for drugs that are primarily eliminated by renal excretion, including many antimicrobial agents and enoxaparin. Recognition of ARC is hampered by the fact that the standard creatinine-based equations used to estimate renal function are not accurate in this clinical setting and the diagnosis is best established using both serum and urine creatinine measurements to calculate clearance. So a high index of clinical suspicion and awareness is usually required before this step is taken to confirm the diagnosis of ARC.

5-Hydroxytryptamine(5-HT)이 개의 신장기능에 미치는 영향 (Effect of 5-Hydroxytryptamine(5-HT) on Renal Function in Dog)

  • 고석태;나한광;최인
    • Biomolecules & Therapeutics
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    • 제4권1호
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    • pp.7-18
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    • 1996
  • 5-Hydroxytryptamine(5-HT, serotonin), when given into the vein, produced antidiuretic action accompanied with reduction of glomerular filtration(GFR), renal plasma flow(RPF), osmolar clearance(Cosm) and amounts of sodium or potassium excreted in urine( $E_{Na}$ , $E_{K}$), with the augmented reabsorption rates of sodium and potassium in renal tubules. 5-HT, when infused into a renal artery, exhibited diuretic action accompanied with the augmented RPF and increased $E_{Na}$ and $E_{K}$ in only infused kidney. Antidiuretic action of 5-HT infused into the vein was not influenced by ketanserin, 5-H $T_2$receptor blockade, given into a renal artery, vein or carotid artery, by methysergide, 5-H $T_1$receptor blockade, given into a renal artery, whereas above antidiuretic action was inhibited by methysergide given into vein or carotid artery. Diuretic action of 5-HT infused into a renal artery in only experimental kidney was blocked by ketanserin injected into a renal artery, was not influenced by methysergide administered into a renal artery. Above results suggest that 5-hydroxytryptamine(5-HT) produced the antidiuretic action through central 5-H $T_1$receptor and the diuretic action through 5-H $T_2$receptor located in renal tubules of kidney.ney.

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상백피가 개의 신장 기능에 미치는 영향 (Influence of Mori Radicis Cortex on the Renal Function of Dog)

  • 고석태;이은화
    • 약학회지
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    • 제26권4호
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    • pp.197-208
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    • 1982
  • In this study attemps were made to obtain evidence as to the action of Mori Radicis Cortex on the renal' function of anesthetized mongrel dogs. 1. A light brown powder isolated from Mori Radicis Cortex (MRC) by a slight modification of Tanemura's method, when given intravenously in doses ranging 0.5 to 5.0mg/kg, elicited diuresis with the increase of positive water clearance and amounts of $Na^{+}$ and $K^{+}$ excreted in the urine. At this time the glomerular filtration rate, renal plasma flow and osmolar clearance were not observed to have any significant changes. This diuresis was augmented in process of time and its maximum effect was exhibited about 30 minutes after administration of MRC. 2. The MRC, when administered into a intra carotid artery, responded promptly with diuresis and natriuresis at a level too small to effect renal functions when administered intravenously. In this experiment the patterns of changes of renal function were the patterns of changes of renal function were the same as those of the above intravenously administered experiment. 3. When infused directly into a renal artery, the MRC exhibited little effect on either kidney. 4. During water diuresis, the MRC did not elicit diuretic action or significant changes in renal functions. The above observations suggest that the diuresis of MRC is brought about by the inhibition of the release of antidiuretic hormone with the mechanism facilitating the excretion of $Na^{+/}$ and $K^{+}$ in urine.

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Effects of Dietary Rna and Adenine on Feed Intake and Kidney Weight and Function in Adult Cockerels

  • Kubota, T.;Karasawa, Yutaka
    • Asian-Australasian Journal of Animal Sciences
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    • 제10권3호
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    • pp.260-264
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    • 1997
  • This study was conducted with adult cockerels to determine whether dietary RNA affects feed intake and renal weight and function, and if the responses are similar to dietary adenine. Chickens were ad libitum fed a RNA diet (100 g/kg) or an adenine diet (9.1 g/kg) for 14 d and catheterized in right jugular vein, hepatic portal vein and both urethers, and saline together with para-amino hippuric acid and sodium thiosulfate was continuously infused into them to evaluate renal functions. Dietary RNA reduced feed intake and body weight, and dietary adenine increased kidney weight expressed as a proportion of body weight (P < 0.05). Feed intake and body weight on the adenine diet and kidney weight on the RNA diet showed similar though non significant tendencies. No calculi were detected in the kidney in chickens fed either the RNA or adenine diets. Plasma inorganic phosphate (IP), Ca and 1,25 $(OH)_2$ vitamin $D_3$ concentrations were increased by dietary RNA and adenine, although the increases of IP and Ca in adenine-fed chickens were not significant. Uric acid and urea concentrations in the blood plasma were unaffected by dietary RNA or adenine. Both dietary RNA and adenine increased renal blood flow rates 3.5-3.7 fold, renal plasma flow rates 3.4-3.7 fold and glomerular filtration rates (GFR) 2.9-3.0 fold (p < 0.01). Clearance of urea, IP and Ca were also enhanced by dietary RNA, but not by dietary adenine. However, neither RNA nor adenine affected uric acid clearance. Only IP clearance was significantly augmented at the glomerular level by dietary RNA (p < 0.05). Glomerular filtration of uric acid, urea, IP and Ca and reabsorption of urea, IP and Ca at the renal tubule were increased by dietary RNA and adenine (p < 0.05), whereas tubular secretion of uric acid was decreased by both dietary treatments. It is concluded that dietary adenine is effective in changing renal function and P and Ca metabolism in chickens.

혈관질환 억제 효능이 있는 WK-38의 백서 신장 독성연구 (Study on Kidney Toxicities of WK-38 for Treatment Vascular Diseases in Rats)

  • 김은주;이안숙;신선;김성연;장보윤;이호섭;강대길
    • 대한한의학방제학회지
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    • 제17권2호
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    • pp.187-194
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    • 2009
  • The kidney toxicities of WK-38 used for improvement of the vascular diseases, was examined using male and female Sprague-Dawley rats. The male and female rats were divided into 4 groups for intragastrical treatment with doses of 0, 5, 50, and 500 mg/kg/day for 13 weeks, respectively. In all male and female rats treated with WK-38, no mortality and gross pathological findings were shown for 13 weeks. There was substantially no change in body weight in all rats with treatment of WK-38. Urine osmolality as renal functional parameters were not exchanged in all rats treated with WK-38. The renal functional parameters including electrolytes excretory rate, creatinine clearance, and solute-free water reabsorption were significantly augmented on account of increase in urinary volume in female rats treated with WK-38, but not male. In summary, this study demonstrates that WK-38 exhibits no toxicity on kidney in all male and female rats.

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CCR5-mediated Recruitment of NK Cells to the Kidney Is a Critical Step for Host Defense to Systemic Candida albicans Infection

  • Nu Z. N. Nguyen;Vuvi G. Tran;Saerom Lee;Minji Kim;Sang W. Kang;Juyang Kim;Hye J. Kim;Jong S. Lee;Hong R. Cho;Byungsuk Kwon
    • IMMUNE NETWORK
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    • 제20권6호
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    • pp.49.1-49.15
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    • 2020
  • C-C chemokine receptor type 5 (CCR5) regulates the trafficking of various immune cells to sites of infection. In this study, we showed that expression of CCR5 and its ligands was rapidly increased in the kidney after systemic Candida albicans infection, and infected CCR5-/- mice exhibited increased mortality and morbidity, indicating that CCR5 contributes to an effective defense mechanism against systemic C. albicans infection. The susceptibility of CCR5-/- mice to C. albicans infection was due to impaired fungal clearance, which in turn resulted in exacerbated renal inflammation and damage. CCR5-mediated recruitment of NK cells to the kidney in response to C. albicans infection was necessary for the anti-microbial activity of neutrophils, the main fungicidal effector cells. Mechanistically, C. albicans induced expression of IL-23 by CD11c+ dendritic cells (DCs). IL-23 in turn augmented the fungicidal activity of neutrophils through GM-CSF production by NK cells. As GM-CSF potentiated production of IL-23 in response to C. albicans, a positive feedback loop formed between NK cells and DCs seemed to function as an amplification point for host defense. Taken together, our results suggest that CCR5-mediated recruitment of NK cells to the site of fungal infection is an important step that underlies innate resistance to systemic C. albicans infection.