Renal function, change

Nitrofurantoin SCr Only if renal function changing or unstable Nitrofurantoin metabolites may accumulate in renal insufficiency and lead to neuropathy avoid in CrCI less than 40 mL/minute... 

Speciai popuiations - Eideriy Acyclovir plasma concentrations are higher in elderly patients compared with younger adults. This may be in part because of age-related renal function changes. 

Renal function changes are readily detectable as amino aciduria and glycosuria. 

Andoh et al developed an experimental model of TAC-induced chronic nephrotoxicity using salt-depletion in rats [687, 704]. A particular characteristic of this model is that renal functional changes and structural injury occur with TAC blood levels equivalent to those found in treated patients, in a striking contrast with the CSA chronic nephrotoxicity model, where extremely high CSA blood levels are necessary to produce injury. In this TAC model, there is an early and dose-dependent decrease in GFR and RBF with a parallel RVR increase followed by a late development of renal interstitial fibrosis involving the itmer strip and medullary rays, arteriolar hyahnosis, tubular atrophy and hypertrophy and medullary thick ascending limb size variance. Structural injury showed a significant positive correlation with decreased renal function [687, 704,705]. 

Aminoglycosides (24-h dosing) Gentamicin, Tobramycin, Amikacin 0.5-3 mg/L Obtain random drug level 12 h after dose After initial dose. Repeat drug level in 1 week or if renal function changes... 

Vancomycin Trough 5-15 mg/L Peak 25-40 mg/L Trough Immediately prior to dose Peak 60 min after a 60 min infusion With 3rd dose (when initially starting therapy, or after each dosage adjustment). For therapy less than 72 h, levels not necessary. Repeat drug levels if renal function changes... 

Relative to adults, babies have increased total body water and extracellular water. Renal function changes with age. Guidelines for fluid and electrolyte replacement therapy in babies are quite different from those in adults. 

Vadiei, K., K. L. Berens, and D. R. Luke. 1990. Isolation-induced renal functional changes in rats from four breeders. Laboratory Animal Science 40 56-59. 

Walker DR (1990) Renal functional changes associated with VUR. Urol Clin N Am 17 307-316 Walsh G, Dubbins PA (1996) Antenatal renal pelvis dilatation a predictor of VUR AJR 167 897-890... 

Severe hypertension with or without allograft dysfunction is the most frequent clinical symptom. Hypertension is a common feature in transplant recipients (up to 80%). Therefore, as for native kidneys, RAS is specifically suspected when hypertension develops suddenly, rapidly becomes more severe and resistant to medical therapy, and is associated with graft dysfunction without any other cause or when associated with an audible bruit over the graft (Palleschi et al. 1980 Rijksen et al. 1982). It may account for around l%-5% of post-transplant hypertension. However, at present, early RAS are often detected systematically with color flow US, despite no blood pressure or renal function change. 

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