Kidneys summary

Henrich WL, Agodoa LE, Barrett B, Bennett WM, Blantz RC, Buckalew VM Jr, D Agati VD, De Broe ME, Duggin GG, Eknoyan G. Analgesics and the kidney summary and recommendations to the Scientific Advisory Board of the National Kidney Foundation from an Ad Hoc Committee of the National Kidney Foundation. Am J Kidney Dis 1996 27(1) 162-165. 

Metabolism. Absorption, distribution, metaboHsm, and excretion of thioglycolic acid have been reviewed (20). In summary,. -thioglycolic acid was absorbed significantly after appHcation to the skin of rabbits. After intravenous injection, the greatest counts of radioactivity were found in the kidneys, lungs, and spleen of monkey and in the small intestine and kidneys of rat. Most of the radioactivity was rapidly excreted in the urine in the form of inorganic sulfate and neutral sulfur. 

The Summary Drug Table Diuretics lists examples of die different types of diuretic drugp. Most diuretics act on die tubules of die kidney nephron (Pig. 46-1), the functional unit of the kidney. Each kidney contains about one million nephrons, which filter die bloodstream to remove waste products. During diis process,... 

A summary of the properties of the different types of dextrans available is presented in Table 25.1. Dextrans for clinical use as plasma expanders must have moleeular weights between 40000 (= 220 glucose units) and 300000. Polymers below the minimum are excreted too rapidly fiom the kidneys, whilst those above the maximum are potentially dangerous because of retention in the body. In practice, infusions containing dextrans of average molecular weights of40000,70000 and 110000 are commonly encountered. 

Calcium is the major mineral component of bone and normal repair and remodelling of bone is reliant on an adequate supply of this mineral. Calcium uptake in the gut, loss through the kidneys and turnover within the body are controlled by hormones, notably PTH and 1,25 dihydroxy cholecalciferol (1,25 DHCC or 1,25 dihydroxy vitamin D3 or calcitriol). Refer to Figure 8.12 for a summary of the involvement of PTH and vitamin D3 in controlling plasma calcium concentration. These two major hormones have complementary actions to raise plasma calcium concentration by promoting uptake in the gut, reabsorption in the nephron and bone resorption. Other hormones such as thyroxine, sex steroids and glucocorticoids (e.g. cortisol) influence the distribution of calcium. 

The urea diffuses out of the liver and is carried to the kidney for excretion. The ornithine that is produced continues the cycle. A summary of... 

Scala RA Comments on Structure-Activity Relationships, Summary and Concluding Remarks, pp IM. Unpublished addendum to Workshop on the Kidney Effects of Hydrocarbons. Boston, 1984... 

In summary, the presence of other medical disorders, other nonpsychotropic agents, expectable changes with aging, and a decreased functional reserve in certain organ systems (e.g., the brain or the kidney) make elderly patients a more difficult population for drug treatment. 

Renal Effects. A summary of autopsy findings in 76 cases of acute diazinon poisoning described renal signs that included congested kidney and rare renal tract and kidney cortex submucosal petechiae and ecchymoses (Limaye 1966). 

In summary, pazopanib (1) is an orally administered, new and potent VEGFR inhibitor and is the approved treatment for advance renal cell carcinoma (RCC), the most common type of kidney cancer. More than 2,000 patients have been treated to date in clinical trials, with potent antitumor activity for RCC. 

Figure 33-3. Summary of the renin-angiotensin-aldosterone system. Aldosterone secretion is controlled by several factors, including increased K+,ACTH, or angiotensin II.A1-dosterone acts to increase Na+ retention by both the kidney and colon.Aldosterone also promotes renal K+ excretion, which contributes to maintenance of Na+/K+ balance. In the absence of aldosterone, Na+ is lost, K+ is enhanced, the extracellular fluid volume is reduced, and mean arterial pressure and renal perfusion pressure are decreased. As a result, renin secretion is increased, leading to increased formation of angiotensin II, which promotes vasoconstriction and aldosterone secretion.

In summary, glucose can be synthesized in the liver and kidney from lactate and noncarbohydrate precursors (carbons from certain amino acids). The synthesis is accomplished essentially by a reversal of the glycolytic pathway, because the cells of these tissues possess the enzymes that are necessary to overcome the three irreversible glycolytic steps. 

Regular blood tests are required to check for cytopenia, especially neutropenia. The Summary of Product Characteristics for hydroxycarbamide states The complete status of the blood, including bone marrow examination, if indicated, as well as kidney function and liver function should be determined prior to, and repeatedly during, treatment. The determination of haemoglobin level, total leukocyte counts, and platelet counts should be performed at least once a week throughout the course of hydroxycarbamide therapy. If white blood cell count falls below 2.5 x 109/L or platelet count to <100 x 109/L, therapy should be interrupted. Counts should be rechecked after 3 days and treatment resumed when they rise significantly towards normal. 

In summary, parenteral pentamidine administration for the treatment of PCP can be associated with the development of usually mild, reversible acute kidney injury. Compounding risk factors, of which volume depletion is the most important, are found in the majority of cases of pentamidine nephrotoxicity. There is no convincing evidence that the aerosol route of pentamidine administration for PCP prophylaxis results in nephrotoxicity. Hypocalcemia and hypomagnesemia with renal magnesium wasting, and particularly, hyperkalemia are seen with pentamidine therapy. 

Bennett WM, Henrich WL, Stoff JS, Bennett WM, Henrich WL, Stoff JS.The renal effects of nonsteroidal anti-inflammatory drugs summary and recommendations. American Journal of Kidney Diseases 1996,-28 S56-S62. 

In summary, virtually all anesthetic agents and techniques are associated with reductions in glomerular filtration rate and urine output. These changes are usually readily reversed in the immediate postoperative period and represent the net effect of complex interactions between direct actions of the anesthetics on the kidney and indirect changes in cardiac output, blood pressure, and neuroendocrine function. 

In summary, the available information indicates that sevoflurane anesthesia is nontoxic to the kidney... 

In summary, other symptoms of IFNa toxicity are far more common than nephrotoxicity (fevers, chills, malaise, arthralgias, fatigue anorexia, weight loss, depression, impaired cognihve function, diminished libido, abnormal thyroid function). Nevertheless, IFNa has a complicated and important relationship to the kidney but there are many confounding factors... 

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