Maturation of Renal Function in Childhood:  Clearance Studies12

Rubin, Mitchell I.; Bruck, Erika; Rapoport, Milton; Snively, Marjorie; McKay, Helen; Baumler, Alverna

doi:10.1172/jci102149

Cited by 246 publications

(126 citation statements)

References 14 publications

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“…In this diagram, the elipse represents the perimeter of a normal surface within which 70%o of normally correlated values would be expected to fall. The statistical background for the elipse was calculated from the data of Rubin, Bruck, and Rapoport (49). Spontaneous or induced (ACTH) improvement of the nephrotic syndrome was usually associated with an increased filtration fraction.…”

Section: Renal Plasma Flowmentioning

confidence: 99%

The Nephrotic Syndrome in Children. An Interpretation of Its Clinical, Biochemical, and Renal Hemodynamic Features as Variations of a Single Type of Nephron Disease 12

Metcoff¹,

Kelsey²,

Janeway³

et al. 1951

J. Clin. Invest.

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Section: Renal Plasma Flowmentioning

confidence: 99%

The Nephrotic Syndrome in Children. An Interpretation of Its Clinical, Biochemical, and Renal Hemodynamic Features as Variations of a Single Type of Nephron Disease 12

Metcoff¹,

Kelsey²,

Janeway³

et al. 1951

J. Clin. Invest.

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“…Rates of flow reach mature levels (1,200 ml/min/1.73 Numerous studies have shown that renal blood flow m 2 ) by 1 year of age [2,24,28]. (RBF), as estimated from hematocrit and clearance Data available in other species, including dog (unof/>-aminohippurate (CPAH); is l°w immediately after published observations in this laboratory), sheep [1], birth and increases steadily during year 1 of life.…”

Section: Introductionmentioning

confidence: 99%

Maturational Changes in Renal Blood Flow in Piglets

1970

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ExtractCardiac output, renal blood flow, and intrinsic renal vascular resistance were measured in piglets ranging in age from 6 h to 45 days. During this period of time the mean cardiac output increased from 0.9 to 6.5 liters/min/m . These data demonstrate that the large increase in renal blood flow in the pig during the first 6 weeks of life was due to both an increase in cardiac output as well as a decrease in renal vascular resistance. By 6 weeks of age, cardiac output was at adult levels. Since in the adult pig the kidney receives 20 % of the cardiac output, increases in renal blood flow beyond 6 weeks of age must result from further decreases in renal vascular resistance. SpeculationIn the human infant, cardiac index is comparable to values observed in the adult. It appears, therefore, that the entire increase in renal blood flow observed during year 1 of life is due to steadily decreasing renal vascular resistance. Since glomerular filtration rate is modified by the relative resistances in the glomerular afferent and efferent arterioles, the parallel increases in filtration rate during infancy may be related to the same mechanism.Introduction mates renal plasma flow by not more than 30-40%. Rates of flow reach mature levels (1,200 ml/min/1.73 Numerous studies have shown that renal blood flow m

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“…The 100-percent value used for para-aminohippurate clearance (CPAH) was 594 ml/min/1.73 m 2 for girls and 697 ml/min/1.73 m 2 for boys [9,22,24, 27], with a standard deviation of ±102.4 for girls and ±135.9 for boys.…”

Section: Methodsmentioning

confidence: 99%

“…The 100-percent value utilized for the tubular maximum excretory capacity for para-aminohippurate (TmPAH) was 77.5 mg/min/1.73 m 2 for both sexes with a standard deviation of ± 12.9 [9,22,24,27].…”

Section: Methodsmentioning

confidence: 99%

Alterations in Renal Cortical Blood Flow in Infants and Children with Urinary Tract Infections

et al. 1968

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ExtractThe present studies were designed to elucidate renal functional changes in infants and children with urinary tract infections. Twenty-three infants and children ranging in age from 4 months to 13 6 / 12 years with urinary tract infections were studied. Four children ranging in age from 2 to 6 10 / 12 years without documented urinary tract infections served as controls. Inulin clearances (Gi) were utilized for measurement of glomerular filtration rate. Renal plasma flow and tubular maximum excretory capacity were ascertained by the intravenous administration of para-aminohippurate (PAH). Second determinations performed in eight patients and a third determination in one patient provided longitudinal follow-up. Renal plasma flow measurements were low in 4 of 6 infants and in 6 of 17 children on initial testing; these decreased values were associated with normal glomerular filtration rates except in 3 subjects. In the 4 patients without documented urinary tract infections, G PAH values were within the normal range. G PAH values obtained initially in all subjects were compared on a surface area basis to those characteristic of normal children. Of the 27 experimental points, 21 were below the line representing the normal average C PAH for children. In this small series, only one of three infants failed to recover this function at the time of repeat testing. The recovery rate was less in the children studied. The data indicate that a decrease in renal plasma flow occurs prior to significant alterations in the other renal functional parameters measured.Twenty-two subjects were tested for both G PAH and Tm P AH-The ratio (G PAH /Tm PAH ) was lower in all three groups than the reported normal value of 7.7. In those patients demonstrating an initially reduced value, 13 of 16 showed normal G PAH values. These findings could represent renal ischemia of proximal tubular tissue.The persistence of renal vascular changes in the face of absent clinical and/or laboratory evidence of urinary tract infections emphasizes the need for caution in identifying the prognosis of children with pyelonephritis and the need for careful long-term evaluation. SpeculationAlthough it has been well documented that the renal medulla is the primary site of involvement in pyelonephritis, the current data suggest that the post-glomerular capillaries and tubular structures in the renal cortex are also early sites of involvement in infants and children. A question raised by the study is the relation of reduced renal plasma flow measurements to the natural history and pathogenesis of recurrent pyelonephritis. It is suggested that agents promoting a change toward normal renal circulation may reverse the pathologic process.

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Maturation of Renal Function in Childhood: Clearance Studies12

Abstract: Evidence has been presented by several investigators that functional capacity of the kidney in the premature and young infant is lower than in older children and adults. Schoenthal (1) using urea clearance, McCance and Young (2) urea and inulin clearances, Barnett (3) inulin clearance, and

Cited by 246 publications

References 14 publications

The Nephrotic Syndrome in Children. An Interpretation of Its Clinical, Biochemical, and Renal Hemodynamic Features as Variations of a Single Type of Nephron Disease 12

The Nephrotic Syndrome in Children. An Interpretation of Its Clinical, Biochemical, and Renal Hemodynamic Features as Variations of a Single Type of Nephron Disease 12

Maturational Changes in Renal Blood Flow in Piglets

Alterations in Renal Cortical Blood Flow in Infants and Children with Urinary Tract Infections

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