Effect of Aortography on Renal Hemodynamics in Normal Man

Nk, Hollenberg; Sm, Rosen; Jf, O'Connor; Ej, Potchen; Basch, Richard I.; Jb, Dealy; Jp, Merrill

doi:10.1097/00004424-196803000-00006

Cited by 17 publications

(3 citation statements)

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“…Only 40 ml contrast medium was injected into the descending aorta and, although the weights of the patients were not given, it can be assumed that the dose of contrast was less than 1 ml/kg, a dose much less than that given to our patients. In the adult group studied before angiography, blood flow and fractional flow were similar to that obtained in the group examined 30-120 min after angiography [27]. Our repeat studies were performed within 30 min.…”

Section: Eflecl Of Angiography On Kidneysupporting

confidence: 76%

Intrarenal Blood Flow in Children with Normal Kidneys and Congenital Heart Disease: Changes Attributable to Angiography

1974

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ExtractThirty 133Xe determinations of renal blood flow were made in 20 children ranging in age from l9f2 to I09i2 years. I n six normal kidneys average blood flows to the outer and inner cortex were 374 and 44 ml/min/100 g, respectively. Mean fractional flows to these areas were 84 and 15 ml/min/100 g, respectively. I n nine children with congenital heart disease (CHD) who were not in congestive heart failure and who were evaluated before angiography, a defect in outer cortical flow was demonstrated. Average blood flows to the outer and inner cortex were 250 ml/min/100 g ( P 0.0005) and 27 ml/min/100 g ( P 0.22). Mean fractional flows were 76y0 ( P 0.03) and 24% ( P 0.015), respectively.After cardiac angiography, a decrease in outer cor~ical flow occurred. The second flow study was performed 8-30 min after injection of contrast media (Hypaque-M, 75%) in amounts which ranged from 1.2 to 3.5 ml/kg body wt. After angiography, blood flows to the outer and inner cortex were 186 ml/min/100 g ( P 0.001) and 24.5 ml/min/100 g (P 0.68). Average fractional flow to the outer, 74y0 and inner: Z6Y0 cortex, did not change ( P 0.71). SpeculationKidneys of children with CHD have decreased outer cortical flow, which may result in increased renal renin production. Therefore, a child with CHD may suffer the long term consequences of hyperreninemia. Furthermore, the balance of any metabolic system whose metabolic pathways involve the outer cortex may be altered and hemodynamic response to stressful clinical situations may be greater in the kidneys of children. Zntroclz~ctioninjecting a bolus of into the renal artery and monitoring the rate of disappearance of the isotope by Although inforlnation of major importance relative to ol external counting devices over the renal blood flow (RBF) has been obtained using the kidney. Graphic analysis of the resultant data provides radionucleide 01 the inert gas, xenon (l3%e), in aniinformation relative to both the rate of nutrient flow rnals and in human adult subjects, this technique has and the fraction of total Aow which perfuses the outer not been used previously to invastigate problems speand inner cortical regions of the kidney. That the cifically related to pediatrics. The RBF is determined by 13"e technique provides useful hemodynamic data in

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Section: Eflecl Of Angiography On Kidneysupporting

confidence: 76%

Intrarenal Blood Flow in Children with Normal Kidneys and Congenital Heart Disease: Changes Attributable to Angiography

1974

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“…Cm , is characterized by a half-time ranging from 150 to 300 sec, and is thought to represent inner medullary perfusion. This component has previously been de monstrated to be sensitive to urine flow rates, becoming significantly more rapid in patients undergoing a brisk diuresis [22]. Several lines of evidence have suggested that the most rapid exponential, Ci, re presents cortical perfusion [2,4,7,12,18,19,32], These three com ponents were all identifiable in patient H.Y.…”

Section: Introductionmentioning

confidence: 84%

Renal ‘Salt Wasting’ Despite Apparently Normal Renal, Adrenal and Central Nervous System Function

Epstein¹,

Hollenberg²

1979

Nephron

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The inability of the kidney to conserve sodium appropriately in response to a restricted sodium intake is reported in a subject who had entirely normal renal and adrenal function and no evidence of central nervous system disease. Subsequent transplantation of his left kidney to his son afforded a unique opportunity to assess renal sodium conservation in each kidney separately: both the patient and his son were unable to achieve balance in response to dietary sodium restriction after transplantation, indicating that the sodium wasting was due to a process intrinsic to both kidneys. The assessment of intrarenal hemodynamics with xenon-133 washout prior to nephrectomy provided insight into the role of intrarenal hemodynamics in the maintenance of sodium homeostasis in man. The xenon washout curve failed to disclose an identifiable second most rapid exponential (C_II). This finding, in concert with previous studies demonstrating that diuretic agents with a primary action in the ascending limb of the loop of Henle cause a marked slowing of C_II flow, raises the possibility that limited perfusion in the outer medulla of the kidney may be rate-limiting for sodium conservation in man.

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“…The hypothesis is that either a decrease in blood flow and/or oxygen tension can lead to necrosis of the medullary thick ascending limbs and subsequent re-nal failure. In contrast to the the steal hypothesis are findings in studies with microspheres in animals and humans after the administration of contrast material that showed no evidence of a redistribution of blood flow from the medulla to the cortex (23,24). Agmon et al in 1994 (25) actually showed an increase in medullary blood flow after contrast material administration in rats.…”

Section: Hemodynamic Effectsmentioning

confidence: 97%

Contrast Medium–induced Nephrotoxicity: Which Pathway?

Katzberg¹

2005

Radiology

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Effect of Aortography on Renal Hemodynamics in Normal Man

Cited by 17 publications

References 0 publications

Intrarenal Blood Flow in Children with Normal Kidneys and Congenital Heart Disease: Changes Attributable to Angiography

Intrarenal Blood Flow in Children with Normal Kidneys and Congenital Heart Disease: Changes Attributable to Angiography

Renal ‘Salt Wasting’ Despite Apparently Normal Renal, Adrenal and Central Nervous System Function

Contrast Medium–induced Nephrotoxicity: Which Pathway?

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