Intravenous Urea Therapy in Glaucoma

Crews, S. J.; Davidson, Sidney I.

doi:10.1136/bjo.45.12.769

Cited by 17 publications

(3 citation statements)

References 10 publications

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“…The infused markers were well tolerated at the dosages used, even in dogs with advanced CKD, and no clinical adverse effects were observed. These findings are in accordance with clinical experience in humans when urea has been used at similar dosages for osmotic treatment of glaucoma and cerebral edema 25,26 . The obtained plasma disappearance curves of urea were highly reproducible in normal dogs and the dosage of 1,000 mg/kg was appropriate for kinetic analysis.…”

Section: Discussionsupporting

confidence: 87%

“…These findings are in accordance with clinical experience in humans when urea has been used at similar dosages for osmotic treatment of glaucoma and cerebral edema. 25,26 The obtained plasma disappearance curves of urea were highly reproducible in normal dogs and the dosage of 1,000 mg/kg was appropriate for kinetic analysis. Simplification of the method with intragastric administration of urea was found to be inadequate in humans, presumably because of the hydrolysis of urea by gastric Helicobacter spp.…”

Section: Discussionmentioning

confidence: 92%

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Quantitative Assessment of Urea Generation and Elimination in Healthy Dogs and in Dogs with Chronic Kidney Disease

Steinbach¹,

Binkert²,

Schweighauser³

et al. 2010

Journal of Veterinary Internal Medicine

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Background: Kinetic assessment of urea, the main end product of protein metabolism, could serve to assess protein catabolism in dogs with chronic kidney disease (CKD). Protein malnutrition and catabolism are poorly documented in CKD and they often are neglected clinically because of a lack of appropriate evaluation tools.Hypothesis: Generation and excretion of urea are altered in dogs with CKD. Animals: Nine dogs with spontaneous CKD (IRIS stages 2-4) and 5 healthy research dogs. Methods: Endogenous renal clearance (Cl renal ) of urea and creatinine was measured first. Exogenous plasma clearance (Cl plasma , total body clearance) of the 2 markers then was determined by an IV infusion of urea (250-1,000 mg/kg over 20 minutes) and an IV bolus of creatinine (40 mg/kg). Extrarenal clearance (Cl extra ) was defined as the difference between Cl plasma and Cl renal . Endogenous urea generation was computed assuming steady-state conditions.Results: Median Cl renal and Cl extra of urea were 2.17 and 0.21 mL/min/kg in healthy dogs and 0.37 and 0.28 mL/min/kg in CKD dogs. The proportion of urea cleared by extrarenal route was markedly higher in dogs with glomerular filtration rate o1 mL/kg/min than in normal dogs, reaching up to 85% of the total clearance. A comparable pattern was observed for creatinine excretion, except in 1 dog, Cl extra remained o20% of Cl plasma .Conclusion: Extrarenal pathways of urea excretion are predominant in dogs with advanced CKD and justify exploring adjunctive therapies based on enteric nitrogen excretion in dogs. A trend toward increased urea generation may indicate increased catabolism in advanced CKD.

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Section: Discussionsupporting

confidence: 87%

Section: Discussionmentioning

confidence: 92%

Quantitative Assessment of Urea Generation and Elimination in Healthy Dogs and in Dogs with Chronic Kidney Disease

Steinbach¹,

Binkert²,

Schweighauser³

et al. 2010

Journal of Veterinary Internal Medicine

View full text Add to dashboard Cite

show abstract

“…It was soon realized that serious side-effects elicited by urea bespeaks the necessity for extreme caution in its administration. These adverse reactions include anorexia, nausea, vomiting [5], electrocardiographic changes [6], cyanotic pallor [7], uncontrolled diuresis, headache, mental confusion, thrombophlebitis and hyperthermia [8].…”

Section: Discussionmentioning

confidence: 99%