• Title/Summary/Keyword: Renal blood flow

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Studies on the Hemodynamic Changes in Cirrhosis of the Liver (간경변증(肝硬變症)에서의 혈역학적(血力學的) 변화(變化)에 관(關)한 연구(硏究))

  • Kim, Jung-Il;Lee, Jung-Sang;Koh, Chang-Soon
    • The Korean Journal of Nuclear Medicine
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    • v.4 no.2
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    • pp.11-27
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    • 1970
  • Cardiac output, plasma volume and renal plasma flow were determined to evaluate hemodynamic changes in 29 patients with cirrhosis of the liver. The results obtained were as follows. 1. The mean plasma volume was 3793+895ml and it was significantly higher than the normal controls. The mean blood volume ($5266{\pm}1222ml$) and blood volume per kg body weight ($95.7{\pm}23.41ml$) were also increased significantly. The mean plasma volume per kg body weight ($69.1{\pm}19.1ml$) showed increased tendency and the mean difference between blood volume and plasma volume per kg body weight ($26.4{\pm}7.05ml$) was in lower limit of normal range. 2. The mean cardiac output was $7708{\pm}2652ml/min$ and it was significantly increased. The mean cardiac index ($4924{\pm}1998ml/min/M^2$), stroke volume ($96.2{\pm}34.2ml/beat$), stroke index ($62.3{\pm}27.34ml/M^2$) and fractional cardiac index ($1.54{\pm}0.577$) were also increased significantly. The mean total -peripheral resistance was $1664{\pm}753.8\;dynes\;sec\;cm^{-5}M^2$ and it was significantly lower than the normal controls. 3. The mean renal plasma flow was $537{\pm}146.8ml/min/1.73M^2$ and it was normal to decreased tendency. The mean endogenous creatinine clearance ($66.7{\pm}23.0ml/min/1.73M^2$) was significantly decreased. Filtration fraction was variable, but it was slightly lower than normal in most cases. The mean renal fraction of cardiac output ($11.4{\pm}6.27%$) was relatively decreased. 4. Although renal plasma flow was normal or decreased in general, it was definitely diminished in patients with creatinine clearance less than $60ml/min/1.73M^2$, resistant ascites, and signs of azotemia (elevated BUN and serum creatinine). 5. Diminished glomrular filtration rate with low filtration fraction and decreased renal fraction of cardiac output observed strongly supported increased renal afferent arteriolar resistance. 6. Renal circulatory impairment preceded azotemia or oroliguria in cirrhosis. 7. Clinical findigns and liver function were not correlated with hemodynamic changes, except for esophageal varices associated with high cardiac output obsedved. 8. No definite correlation of renal hemodynamics with plasma volume or cardiac output was found.

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Changes of the Renal Arteries According to Various Embolic Materials (다양한 색전물질에 의한 신동맥의 변화)

  • Cho, Jae-Ho;Cho, Kil-Ho;Chang, Jae-Chun;Park, Bok-Hwan;Kim, Dong-Sug
    • Journal of Yeungnam Medical Science
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    • v.12 no.1
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    • pp.96-104
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    • 1995
  • The transarterial embolization has been widely used to control bleeding. It has a variety of clinical utility; to reduce bleeding on the surgical field, to reduce the size of malignant tumor as a preopearative treatment, to treat arteriovenous malformation or arterial aneurysm as a curative method and to promote life quality of patient with diffuse or multiple hepatocellular carcinoma as a palliative treatment, etc. With the advance of modem technology, various embolic materials have been also developed. However, it has not been fully investigated of histopathologic changes of the embolized organs according to the embolic materials used. This study was undertaken to investigate the histopathologic changes of embolized renal artery in rabbit by various embolic materials, according to each embolic material and to time passed by after embolization. Of the 5 arteries embolized by ethylene vinyl alcohol copolymer(EVAL), one showed abscess formation in embolized kidney. The other 4 allowed to perform further pathologic study: within a week after embolization there was no any specific change in vessels, however, minimal endothelial hypertrophy was observed following 2 weeks of embolization. Of the 8 renal arteries embolized by N-buthyl-2-cyanoacrylate(Histoacryl), 4 showed total occlusion of the main renal arteries as well as renal infarction, which reflects the strong adhesiveness of Histoacryl to vascular wall. The other 4 showed fibrinoid degeneration in vascular wall within a week. However, further change was not observed thereafter. In all the 5 renal arteries embolized by polyvinyl alcohol(Ivalon), there were infiltration of inflammatory cells along the vessel walls, within one week, which represents vasculitis. They showed some fibrosis with appearance of giant cells in the vessel wall two weeks after embolization and also showed marked fibrosis of connective tissues surrounding vessels two months after embolization, respectively. The results suggest that EVAL is useful for the embolization of hypervascular lesion with limited arteriovenous fistula, Histoacryl for the curative treatment of the lesion with high blood flow or severe arteriovenous fistula, and Ivalan for palliative treatment of malignant tumor or arteriovenous malformation, respectively.

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Study for the Effect of CWS-A on the Cerebral Hemodynamic Changes and the Safety Examination (CWS-A 방의 뇌혈류역학적 변화 및 안전성에 관한 연구)

  • Choi, Chan-Hun;Kim, Jeong-Sang;Jeong, Hyun-Woo;Song, Min-Sun;Chae, Woo-Seok
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.26 no.1
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    • pp.19-25
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    • 2012
  • This study was designed to investigate the effects of a new herbal medicine named CWS-A on the changes in regional cerebral blood flow (rCBF) and mean arterial blood pressure (MABP) in normal rats, and further to determine the mechanism of action. Also, this study was designed to investigate the effects of CWS-A on the changes in rCBF in cerebral ischemic rats and the safety examination of CWS-A in rats regared to body weight change, renal and liver function test, CBC, $LD_{50}$ and histological observation in rats. The rCBF was significantly and stably increased and MABP was significantly decreased by CWS-A during the period of cerebral reperfusion in normal rats. However, there were no here were no significant changes of rCBF in ischemic rats. In additional, there were no significant changes on the safety examination. In conclusion, these results suggest that medication of CWS-A is effective for the improve the cerebral blood flow and CWS-A can be prescribed as vertigo(眩暈) symptoms treatment.

Impact of monthly arteriovenous fistula flow surveillance on hemodialysis access thrombosis and loss

  • Ara Ko;Miyeon Kim;Hwa Young Lee;Hyunwoo Kim
    • Journal of Medicine and Life Science
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    • v.20 no.3
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    • pp.115-125
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    • 2023
  • Arteriovenous fistula flow dysfunction is the leading cause of vascular access thrombosis and loss in patients undergoing hemodialysis. However, data regarding the influence of access flow rate measurements on the long-term outcomes of access are limited. This study aims to identify accesses at a high risk of thrombosis and loss among patients undergoing hemodialysis by measuring the access flow rate and exploring an optimal threshold value for predicting future access thrombosis. We enrolled 220 patients with arteriovenous fistula undergoing hemodialysis. The primary outcome was the occurrence of access thrombosis. Access flow rates were measured monthly using the ultrasound dilution method and were averaged using all measurements from patients with patent access. In patients experienced access thrombosis, those immediately before the thrombosis were selected. Using these data, we calculated the access flow rate threshold for thrombosis occurrence by analyzing the receiver operating characteristic curve, and the patients were divided into two groups according to whether access flow rates were higher or lower than 400 mL/min. During a median follow-up period of 3.1 years, 4,510 access flows were measured (median measurements per patient, 33 times; interquartile range, 11-54). A total of 65 access thromboses and 19 abandonments were observed. Access thrombosis and loss were higher in the lowflow group than in the high-flow group. This study revealed that low access flow rates are strongly associated with access thrombosis occurrence and subsequent loss of arteriovenous fistulas in patients undergoing hemodialysis.

A Microfluidic Chip-Based Creatinine Filtration Device (마이크로 플루이딕 칩을 기반으로 한 크레아티닌 여과장치)

  • Lee, Sack;Shin, Dong-Gyu;Nguyen, Thanh Qua;Park, Woo-Tae
    • Transactions of the Korean Society of Mechanical Engineers B
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    • v.39 no.12
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    • pp.921-925
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    • 2015
  • The number of people suffering from renal disease increases every year. One of the most common treatments (clinical care options) for renal diseases is hemodialysis. However it takes a long time and has a high cost. Therefore, the importance of artificial kidney research has risen. Filtering creatinine from blood is one of the prime renal functions. Thus, we designed a novel two channel microfluidic chip focused on that function. In order to bond the individual polydimethylsiloxane layers, we have developed a housing system using acrylic plastic frame. This method has significant advantages in changing filter membranes. We use anodic aluminum oxide for the filter membrane. We analyzed the difference in the absorbance values for various creatinine concentrations using the Jaffe reaction. For the purpose of acquiring a standard equation to quantify the creatinine concentration, we interpolated the measured data and confirmed the concentration of the filtered solution. Through this experiment, we determined how the filtration efficiency depended on the flow rate and creatinine concentration.

Clinical Differences and Outcomes of Continuous Renal Replacement Therapy between Critically Ill Neonates and Children (신생아와 소아의 지속적 신대체요법(CRRT) 적용 특성 및 결과)

  • Choi, Aeng Ja;Choi, Su Jung;Choi, Hee Jung;You, Mi Young
    • Journal of Korean Critical Care Nursing
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    • v.9 no.1
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    • pp.40-50
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    • 2016
  • Purpose: Continuous renal replacement therapy (CRRT) has become the preferred dialysis method to support critically ill children and neonates with acute kidney injury. Using CRRT on neonates has increased, but reports about experience are limited. The aim of this study is to describe the clinical application, outcomes, and complications of CRRT in children and neonates. Methods: A retrospective review was performed in 135 children and 36 neonates who underwent CRRT at a tertiary hospital from 2008 to 2015. Results: At the initiation of CRRT, the median age of children was 72 months and the corrected age of neonates was 37.1 weeks. Median body weight of neonates was 3.2 kg. In neonates, initial degree of fluid overload [FO%], blood flow rate [BFR] and ultrafiltration rate [UFR] rate during CRRT were higher than in children. Median real time of CRRT was 90.5 and 53.5 hours in children and neonates, respectively. Downtime of CRRT was 0.7 and 1.3 hours/day. Median mortality rates (44.4% vs.47.2%) and complication rates were similar between the groups. Conclusion: CRRT can be used for a wide range of critically ill children and neonates. Different application methods of CRRT can contribute to increased survival of neonates.

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Supraceliac Aorta Bypass Surgery For Juxtarenal Aortic Occlussive Disease -2 Cases - (신장근접 대동맥 폐색증의 상복강대동맥 우회술)

  • 오중환
    • Journal of Chest Surgery
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    • v.25 no.1
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    • pp.105-111
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    • 1992
  • Total atherosclerotic obstruction of the juxtarenal abdominal aorta is a relatively rarely encountered form of atherosclerotic vascsular disease, accounting for less than 5% of all arterial obstrutive disease. We have encountered two patients with such lesions, both of whom were admitted for intermittent claudication of the lower extremities and symptoms of vascular ischemia. Digital subtraction angiography[DSA] was performed on both patients, the results of which revealed total obstruction of the aorta just inferior to the renal arteries without involving the latter. Operative technique involved the use of the sup-raceliac aorta as the site of proximal anastomosis of aortofemoral bypass followed by a fem-orofemoral bypass graft with Smm sized Woven Dacron[Vascutek] through a subcutaneous tunnel within the retroperitoneal space. Both patients experienced restoration of blood flow distal to the obstruction postoperatively without any complications, and OPD follow-up one month postoperatively and postoperative DSA showed evidence of continued graft patency with persistent symptomatic improvement.

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Severe Hemolysis after St. Jude Medical Valve Replacement in the Aortic Position -A Redo Case Report - (판막치환술 후 심한 용혈 현상으로 재치환한 경험)

  • 조영철
    • Journal of Chest Surgery
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    • v.21 no.4
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    • pp.706-710
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    • 1988
  • Intravascular hemolysis occurs in the majority of patient with mechanical valve prosthesis. The primary cause is mechanical trauma to red cells from turbulent blood flow through the prosthesis. Degree of hemolysis is dependent upon the type, size and material of valve and aggravated by paravalvular leakage. Clinically important hemolytic anemia is required medical management or consideration of reoperation. In severe hemolysis, reoperation is recommended without delay when seems to be renal failure. In this case, postoperative severe mechanical hemolysis was developed immediately after aortic valve replacement with St. Jude medical valve in a 13 year-old male patient. Neither significant paravalvular leakage nor valvular dysfunction was found through redo, but the mechanical valve was strongly suspected the cause of severe hemolysis. The St. Jude Medical valve was changed with Ionescu-Shiley bioprosthesis and any significant clinical problems were not noted through the postoperative course.

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Congenital portal vein aplasia with portocaval shunting in two dogs

  • Hwang, Taesung;Moon, Jonghyun;Lee, Hee Chun
    • Korean Journal of Veterinary Research
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    • v.59 no.3
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    • pp.171-173
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    • 2019
  • Two dogs presented with vomiting and head pressing. In both dogs, a large vessel was revealed in computed tomography (CT) angiography, which was found to leave the portal vein (PV) cranial to the splenomesenteric confluence and enter the pre-hepatic caudal vena cava cranial to the right renal vein. The flow of portal blood to the liver was not identified. Based on CT angiography, the dogs were suspected to have congenital PV aplasia with portocaval shunting. Diagnostic imaging of potential malformations for PV continuation should be conducted before attempting shunt closure.

Influence of Intracerebroventricular Domperidone on Rabbit Renal Function (가토 신장기능에 미치는 뇌실내 Domperidone의 영향)

  • Kim, Young-Soo
    • The Korean Journal of Pharmacology
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    • v.24 no.1
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    • pp.135-145
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    • 1988
  • Dopamine when given icv induces antidiuresis along with transient natriuretic tendency, and it has been suggested that both subtypes of central dopamine receptors may influence renal function differentially. This study was undertaken to delineate the role of central $D_2$ receptors employing domperidone (DOM), a selective $D_2$ antagonist. DOM icv elicited antidiuresis and antinatriuresis in doses ranging from 15 to $135{\mu}g/kg$. GFR and RPF as well as sodium excretion decreased. Systemic blood pressure increased slightly. Intravenous DOM did not elicit significant changes in sodium excretion. Denervation of the kidney abolished the hemodynamic change induced by icv DOM, but sodium excretion decreased on both innervated and denervated kidneys. No diuretic tendency was uncovered by the denervation. Dopamine, $150{\mu}g/kg$ icv, produced antidiuresis along with decreases in hemodynamics. These effects were not affected by DOM-pretreatment, and no natriuretic tendency was unveiled. Bromocriptine, a $D_2$ receptor agonist, $200{\mu}g/kg$ icv, elicited marked diuresis and natriuresis, which were completely abolished by DOM-pretreatment. Apomorphine, another prototype of $D_2$ agonist, $150{\mu}g/kg$ icv, produced diuresis and natrituresis with increases in renal hemdoynamics, followed by decreases in all parameters. DOM-pretreatment did not affect the renal hemodynamic effects, wherease the increases in urine flow and sodium excretion were markedly reduced by DOM, Present study suggests that central $200{\mu}g/kg$ receptors mediate natriuretic and diuretic influence to the kidney, possibly through mediation of natriuretic humoral factor, and provide further evidence supporting the hypothesis that central $200{\mu}g/kg$ receptors mediate antidiuretic influence via nerve pathway, whereas natriuresis are brought about through mediation of central $200{\mu}g/kg$ receptors.

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