Renal hemodynamics

B. Arregui, B. Lopez, M.G. Salom, F. Valero, C. Navarro, and F.J. Fenoy, Acute renal hemodynamic effects of dimanganese decacarbonyl and cobalt protoporphyrin. Kidney Int. 65, 564-574 (2004). 

A patient with compromised renal hemodynamics is given a trial of mannitol Of the following, which is the least likely to be associated with the effect of mannitol ... 

ACE inhibitors altered renal hemodynamic regulation (renal failure)... 

Prednisolone can cause an abrupt rise in proteinuria in patients with nephrotic syndrome. A placebo-controlled study in 26 patients aged 18-68 years with nephrotic syndrome has clarified the mechanisms responsible for this (163). Systemic and renal hemodynamics and urinary protein excretion were measured after prednisolone (125 mg or 150 mg when body weight exceeded 75 kg) and after placebo. Prednisolone increased proteinuria by changing the size-selective barrier of the glomerular capillaries. Neither the renin-angiotensin axis nor prostaglandins were involved in these effects of prednisolone on proteinuria. 

Kalambokis G, Economou M, Fotopoulos A, Bokharhii JA, Pappas C, Katsaraki A, Tsianos EV. The effects of chronic treatment with octreotide versus octreotide plus midodrine on systemic hemodynamics and renal hemodynamics and function in nonazotemic cirrhotic patients with ascites. Am J Gastroenterol 2005 100 879-85. 

In contrast to neurogenic hypertension, the role of adrenergic factors in experimental renal hypertension is obscure. The sequence of events by which interference with renal hemodynamics leads to elevation of the systemic blood pressure has been carefully studied and has been shown to be independent of nervous mechanisms (see 11, 35). Sympathectomy does not prevent the development of renal hypertension and induces only slight and irregular reductions in pressure in renal hypertensive animals (3, 28, 55, 97). 

Sympatho-adrenal factors could enter this cycle by increasing the arterial pressure or directly altering renal hemodynamics... 

Nephrotoxicity is caused by drugs that principally affect the renal hemodynamics of the patient depended on vasodilator prostaglandin biosynthesis or angiotensin converting enzyme (ACE) mediated vasoconstriction drugs causing nephrotoxicity include NSAIDs (fenprofen), ACE inhibitors (captopril, and cyclosporin). 

Lim TH, Lee JS, Choi BI, Kim 10, Suh CH, Han MC, Kim CW (1987) An explanation of renal hemodynamics in acute renal failure based on sequential CT in patients with Korean hemorrhagic fever. J Comput Assist Tomogr 11 474-479... 

The determination of renal function in anesthetized animals provides specific information on the effects of chemicals on glomerular filtration rate and renal blood flow. In addition, the ability of the kidney to reabsorb or secrete electrolytes may be determined by fractional clearance of Na+, K+, HCO3, Cl, and so on. Fractional clearance involves comparison of electrolyte clearance to the clearance of a substance such as inulin, which is removed from plasma by glomerular filtration. Thus, fractional clearance takes glomerular filtration rate into account, allowing comparisons of electrolyte transport between treated and control animals even if renal hemodynamics have changed. Nephron function may be assessed by free water clearance, representing the ability of the kidney to remove almost all Na+ from urine. 

Sudo M, Honda N, Hishida A, et al. 1977. Renal hemodynamics in uranyl acetate-induced acute renal failure of rabbits. Kidney Int 11 35-43. 

Lenz, K., Hortnagl, H., Druml, W., Reither, H., Schmid, R., Schneeweiss, B., Laggner, A., Grimm, G., Gerbes, A.L. Ornipressin in the treatment of functional renal failure in decompensated liver cirrhosis. Effects on renal hemodynamics and atrial natriuretic factor. Gastroenterology 1991 101 1060-1067... 

Jacobson SH, Jaremko G, Duraj FF, Wilczek HE. Renal fibrosis in cyclosporin A-treated renal allograft recipients morphological findings in relation to renal hemodynamics. Transpl Int 1996 9(5) 492-8. 

Asberg A, Christensen H, Hartmann A, Berg KJ. Diltiazem modulates cyclosporin A induced renal hemodynamic effects but not its effect on plasma endotheUn-l. Qin Transplant 1998 12(5) 363-70. 

Diamond JR, Cheung JY, Fang LS. Nifedipine-induced renal dysfunction. Alterations in renal hemodynamics. Am J Med 1984 77(5) 905-9. 

Fleyman SN, Rosenberger C, Rosen S. Regional alterations in renal hemodynamics and oxygenation a role in contrast medium-induced nephropathy. Nephrol DialTranspI 2005 20(SI) i6-i11. 

Bradykinin plays an important role in the regulation of renal hemodynamics. The effects of bradykinin on isolated perfused rabbit afferent arterioles and the mechanisms of action of bradykinin was studied [161]. 

Tolins JP, Palmer RM, MoncadaS, Raij L Role of endothelium-derived relaxing factor in regulation of renal hemodynamic responses. Am.J.Physiol 258 H655-H662,1990... 

JocksT, Zahner G, Helmchen U, Kneissler U, Stahl RA Antibody and complement reduce renal hemodynamic function in isolated perfused rat kidney. Am J Physiol 270 179-85,1996... 

Tolins JP, Raij L. Adverse effect of amphotericin B administration on renal hemodynamics in the rat. Neurohumoral mechanisms and influence of calcium channel blockade. J Pharmacol ExpTher 1988 245 594-9. 

Collectively, these studies suggest that COX-2 plays a dominate role in the regulation of salt and water excretion in prostaglandin dependent patient, while the role of COX-1 seems to involve the regulation of renal hemodynamics, including GFR. The Swan et al. [127] study suggests that COX-2 may also play a role in regulating GFR however, the combination of elderly patients who are salt depleted may have provided a more severe hemodynamic stress than was present in the other three studies. 

Johnston HH, Herzog JP, Lauler DP, Johnston HH, Herzog JP, Lauler DP. Effect of prostaglandin El on renal hemodynamics, sodium and water excretion. American Journal of Physiology 1967 213 939-946. 

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