Residual kidney function

Visualization of Residual Contrast Medium on Delayed CT in Relation to the Interval from the Administration of Contrast Medium (Assessment of Regional Kidney Function)... 

Diuretic therapy is beneficial for management of blood pressure in patients with early CKD however, thiazide diuretics are not generally effective in patients with a GFR of <30 mL/min. Loop diuretics can be used throughout all stages of CKD. In most cases the dose must be increased as kidney function declines, to achieve a similar degree of blood pressure reduction. Patients with ESKD who have minimal to no residual renal function are especially poor responders to these agents. 

Patients with less than 10% of normal kidney function require renal replacement therapy for removal of waste metabolites. In patients undergoing hemodialysis, the total clearance of a drug is equal to sum of the clearances due to nonrenal routes of elimination (C/rNu), residual renal function (OrRRp), and the dialyzer (CZrdiaiyzer) ... 

Blood also contains many low molecular weight substances. The content of N-containing, low molecular weight substances varies. The nonprotein nitrogen content (or residual nitrogen, mainly urea, some amino acids, uric acid, creatine, creatinine) is an indicator of kidney function the concentration is usually low be-... 

Natriuretic peptides are a family of peptide hormones. All of them contain a 17-amino acid long ring that is closed by a disulfide bond between two cysteine residues. ANP (atrial natriuretic peptide) is mainly expressed in the atria of the heart, whereas BNP (B-type natriuretic peptide) is synthesized in the ventricular myocardium. CNP occurs mainly in the endothelium and is thought to have a paracrine function. ANF and BNF lower blood pressure by a direct effect on smooth muscle and on the salt retention in the kidney. Natriuretic peptides bind and activate particulate guanylyl cyclases. 

The authors concluded that the mixture induced effects on the liver and the kidney, and on the general metabolism at high doses but caused only minor effects on immune function, reproductive hormone levels, or general indices of reproductive function measures. The results suggested that additive or synergistic effects of exposure to contaminants resulting in residue levels representative of contemporary human tissue levels are unlikely to result in adverse effects on immune function or reproductive physiology in male rats. 

The uptake of glucose by brain, liver, kidneys, erythrocytes, and the islets of Langerhans is unaffected by insulin. However, in muscle and adipose tissues insulin stimulates glucose uptake. Part of this effect results from insulin-induced translocation of molecules of the 509-residue glucose transport protein GLUT4 (Chapter 8) from the cytosol into the plasma membrane where it can function.354-3563 Insulin apparently also increases the rate of synthesis of the transporters. 

A large variation of the duration of the detoxification was noted (Table 1). Only five patients could be treated for less than 10 weeks, while twelve other patients had to be treated for up to 91 weeks. The treatment was discontinued in patients in whom both s-Al and the increment of s-Al after desferrioxamine treatment were below 50 pg/L at two successive occasions). The treatment duration was significantly related to the residual diuresis as all patients with a residual diuresis of a liter/day or more could be treated for less than two months (Fig. 2). Other studies have also established the protective capacity of an even minimal functioning kidney [30, 67]. None of the patients died during treatment with desferrioxamine, and six patients (patient Nos. 11-13, 22, 25, 26) died more than one year after termination of the desferrioxamine treatment, due to causes unrelated to the A1 intoxication. As of November 2001, more than five years after the intoxication episode, 12 of the 17 surviving patients (patient Nos. 11, 12, 14, 16-24) are still alive and none of the patients developed any clinical signs of Al toxicity, like speech disturbances, cognitive defects, bone fractures or dementia-like symptoms. 

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