• Translational and Clinical Pharmacology
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• v.26 no.3
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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.

• YAKHAK HOEJI
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• v.22 no.4
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• pp.207-214
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• 1978

Influence of Akebiae Lignum on the renal function of the dog was observed with water-extract, utilizing clearance technique. Akebiae Lignum water-extract (AWE) given intravenously in does of 3.0mg/kg and 30.0mg/kg elicited a marked antidiuretic effect and produced a distinguished decrease of glomerular filtration rate and renal plasma flow as reduction of sodium and potassium excretion in urine, positive free water clearance and osmolar clearance. AWE infused into a renal artery in doses of 0.03mg/kg/min and 0.1mg/kg/min exhibited identical results to the intravenous action confined only to the infused kidney. These results suggest that AWE elicits antidiuresis in the dog by decreasing glomerulor filtration and renal plasma flow, which are caused by the constriction of vas afferens in the glomeruli.

• The Korean Journal of Nuclear Medicine
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• v.23 no.1
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• pp.49-54
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• 1989

Many previously described nuclear medicine procedures to assess glomerular filtration rate (GFR) required numerous blood samples obtained over a period of several hours to determine plasma concentrations of the injected radiopharmaceuticals. And other indirect methods of determining renal clearance have some problems due to individual variations in volume of distribution of the radionuclides used. Rescently reported Jackson's method have the great advantages that is a direct measurement method requiring less than 40 min of imaging time and single blood sampling. And it correctly accounts for individual variations in volume of distribution of the radiopharmaceuticals and can be done with routine renal scintrgraphy. We measured $^{99m}Tc-DTPA$ renal clearance with Jackson's method during the routine $^{99m}Tc-DTPA$ renal scintigraphy in 63 patients admitted to department of internal medicine in SNUH. In 23 cases among 63 patients creatinine clearence was accounted simultaneously. The range of $Cl_{DPDA}$ was from 19.9 ml/min to 170 ml/min and the correlation of $Cl_{DPDA}$ and creatinine clearance was discribed by Y=16.2570+0.7852 X($X=Cl_{DTPA}$ Y=creatinine clearance). And the correlation coefficient r was 0.88. We concluded that $^{99m}Tc-DTPA$ renal clearance measurement with Jackson's method was clinically useful to account GFR that can be done with routine $^{99m}Tc-DTPA$ renal scintigraphy simultaneously.

• Journal of Pharmaceutical Investigation
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• v.16 no.4
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• pp.152-157
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• 1986

The pharmacokinetics of sulfamethoxazole were investigated in rabbits with folate-induced renal failure. The blood level, area under the blood concentration curve (AUC) and biological half-life were increased significantly, and the urinary excretion was decreased significantly compared with those of normal rabbits. Correlation of serum creatinine concentration and AUC, biological half-life, and correlation of creatinine clearance and renal clearance have linear relationship respectively. From these results, dosage regimen of sulfamethoxazole is considered to be adjusted for effective and safe therapy in renal failure.

• YAKHAK HOEJI
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• v.29 no.4
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• pp.216-219
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• 1985

The phormacokinetics of acetaminophen were investigated in rabbits with folate-induced renal failure. The blood level, the area under the blood concentraction curve(AUC) and the biological half-life were increased significantly, and the urinary excretion was decreased significantly as compared with those of normal rabbits. Serum creatinine concentration and AUC, creatinine clearance and renal clearance have linear relationship respectively. Dosage regimen of acetaminophen was considered to be adjusted in renal failure.

• YAKHAK HOEJI
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• v.35 no.1
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• pp.38-44
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• 1991

It has been reported that the pharmacokinetic behaviors of drugs which are mostly metabolized in the liver are significantly different in patients with renal failure. Theophylline(TP) is mainly metabolized in the liver (approximately 90%) and renal clearance of the drug is negligible (less than 10%). Therefore, we have investigated the changes in pharmacokinetics of theophylline in normal, G-ARF and U-ARF rats after an intravenous administration. The total body clearance of TP decreased approximately 40% in U-ARF rats. The reduced CL$_{T}$, value in U-ARF rats could be due to reduced hepatic intrinsic clearance by up to 40% since it has been published that plasma protein binding of TP and liver blood flow does not change in U-ARF rats.

• Journal of Ginseng Research
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• v.21 no.1
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• pp.49-52
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• 1997

There are many mechanisms that mediate progression of renal injury, such as abnormalities of nitric oxide (NO) regulation, increased Platelet aggregatlon, and oxygen free radical injury. Ginseng has been known to have NO dependent vasorelaxant effect and antioxidant effect, also inhibit thrombin stimulated platelet aggregation. And these effects of ginseng may have some roles in prevention of renal injury. So we studied 24 patients with mild pathologic proteinuria and hypertension to evaluate the effect of ginseng on progression of renal injury. After 1 month treatment, creatinine clearance was significantly increased especially in the patient group with normal serum creatinine level without specific side effect. The result of this study suggest that ginseng may pre vent or retard the progression of renal injury especially in early stage.

• Archives of Pharmacal Research
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• v.13 no.3
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• pp.233-239
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• 1990

The efect of acute renal failure (ARF) on the pharmacokinetics o sulfobromophthalein (BSP) was investigated in order to elucidate if renal failure modifies the hepatic metabolism of drugs. ARF was induced by intravenous (iv) injection of uranyl nitrate (UN) to rats (5 mg/kg) five days before the experiment. Area under the plasma concentration-time curve (AUC)of BSP after portal vein (pv) injection increased by 2-fold and total body clearance ($CL_1$) decreased one half (p <0.01) in UN-induced ARF (UN-ARF) rate compared to the control rats. But the plasma disappearance of BSP after iv injection did not differ significantly between control and UN-ARF rats. Since BSP is excreted via the liver, $CL_1$ represented the approximate hepatic clearance of BSP. Therefore, the decrease in $CL_1$ represented the approximate hepatic clearance of BSP. Therefore, the decrease in $CL_1$ represents a decrease in hepatic intrinsic clearance ($CL_{int}$) for BSP since plasma free fraction ($f_p$) of BSP was not affected by UN-ARF. The content of hepatic cytoplasmic Y-protein, which catalyzes BSP-glutathione conjugation and limits the trasfer of BSP from blood to bile, increased significantly (p < 0.01), however its binding activity (BA) for BSP was decreased significantly (p <0.01) by UN-ARF. The decrease in $CL_{int}$might have some correlation with the changed characteristics of hepatic Y-protein, specifically its decreased BA for BSP.

• YAKHAK HOEJI
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• v.29 no.3
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• pp.130-143
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• 1985

Bumetanide, when given intravenously in dogs, induced a potent diuresis with an increased amounts of sodium and potassium excreted in urine due to inhibition of reabsorbing them in renal tubule. Furthermore, clearances of osmolar substance and para-aminohippuric acid were increased, but clearace of free water diminished without any change of creatinine clearance. Bumetanide, administered directly into a renal artery, elicited diuresis only in the infused(experimental) kidney by the same mode of action as in the intravenous cases in renal function of the dog. Renal effects of intravenous bumetanide after pretreatment with the small dose of indomethacin (5.0mg/kg) revealed reduction only in clearance of paraaminohippuric acid. However the much dose of indomethacin (5.0mg/kg+5.0mg/kg/hr) or arachidonic acid showed a significant inhibition in the change rates of all renal function by bumetanide. Morover, pretreatment of probenecid also made a marked reduction in renal effects induced by bumetanide. From the above results, it is thought that bumetanide causes diuretic action due to dual mechanism inhibiting reabsorption of electrolytes in loop of Henle and increasing blood flow in kindney, that are provoked through the mediation of prostaglandins.

• YAKHAK HOEJI
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• v.28 no.3
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• pp.149-160
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• 1984

In order to certify the diuretic mechanism of dopamine, this study was performed in dog. The following results were obtained. Dopamine, when given intravenously, produced diuresis, and increased glomerular filtration rate (GFR), renal plasma flow (RPF), and amount of sodium excreted in urine. When infused directly into a renal artery, dopamine elicited a marked diuresis confined only to the infused side, with concomitant rises in osmolar clearance and sodium excretion as well as a slight increase in free water clearance. Simultaneously total renal plasma flow and medullary plasma flow increased markedly with a increase of glomerular filtration rate and renal plasma flow. Medullary concentration gradient of sodium also markedly lowered in the infused kidney. These changes were not observed during mannitol diuresis and renal action of dopamine were not apparent in dog pretreated with haloperidol. From the above experimental results, it is thought that dopamine, when given into a vien or infused directly into a renal artery, induces diuresis, and the mechanism of its action is due to dual actions which are hemodynamic effect along with glomerular filtraction rate, and the increased response in the medullary blood flow.