Methemoglobin-Induced Acute Renal Failure in the Rat

Ruiz-Guinazu, A; Coelho, Jaime B.; Paz, Rita

doi:10.1159/000179587

Cited by 74 publications

(15 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In order to account for the nearly complete cessation of glomerular fil tration occurring in acute renal failure [17][18][19][20] in the presence of relatively intact RBF, the components of ultrafiltration pressure must be considered. Hemodynamically, changes in intrarenal arteriolar tone could affect single nephron glomerular filtration rate by altering glomerular capillary pressure [21], Considering this factor alone, a significant increase in afferent arteriolar resistance with attendant decrease in resistance of the efferent arteriole would be required to sufficiently reduce glomerular capillary pressure, so that net ultrafiltration pressure could fall close to zero in lhe presence of normal glomerular blood flow.…”

Section: Discussionmentioning

confidence: 99%

Intrarenal Hemodynamics in Acute Myohemoglobinuric Renal Failure

Hsu¹,

Kurtz²,

Goldstein³

et al. 1976

Nephron

View full text Add to dashboard Cite

Renal blood flow (RBF) and its distribution were measured in acute renal failure induced by glycerol injection to water-drinking rats and to rats chronically loaded with NaCl solution. Mean RBF and intracortical blood flow distribution of both water-drinking and saline-loaded rats at 24 h after glycerol injection were not different from those of control rats. Although chronic saline loading blunted the impairment of renal function caused by glycerol as evidenced by serum creatinine values, no differences in renal hemodynamics were noted. This suggests that changes in glomerular arteriolar resistance or glomerular permeability might be of greater importance in the reduction of glomerular filtration rate than are alterations of blood flow.

show abstract

Section: Discussionmentioning

confidence: 99%

Intrarenal Hemodynamics in Acute Myohemoglobinuric Renal Failure

Hsu¹,

Kurtz²,

Goldstein³

et al. 1976

Nephron

View full text Add to dashboard Cite

show abstract

“…The precise pathogenetic role of intratubular protein casts frequently found in distal tubules remains to be establish ed. Several lines o f evidence support the view that protein casts are not likely to be of primary pathogenetic importance for the developement of pigment nephropathy, since they do not in fluence intratubular pressure [21][22][23][24], Conver sely, other investigators [25][26][27][28] could demon strate elevations of tubular pressure. Thirdly, once stored intracellularly, hemoglobin seems to act cytotoxically via Fc-promotcd oxygenderived free radical generation [29][30][31][32].…”

Section: Introductionmentioning

confidence: 99%

Ultrapure Polymerized Bovine Hemoglobin Improves Structural and Functional Integrity of the Isolated Perfused Rat Kidney

Willinger¹,

Schramek²,

Pfaller

et al. 1995

Kidney Blood Press Res

View full text Add to dashboard Cite

Since it became evident that organ dysfunctions after acute hemolysis are not induced by hemoglobin per se, but by stroma-contaminated hemoglobin, solutions of ultrapure stroma-free hemoglobins were regarded to be possible substitutes for blood in transfusion medicine. We tested one of the recently developed modified bovine hemoglobins (Ultrapure polymerized bovine hemoglobin 1; UPPBHb1) in the isolated perfused rat kidney (IPRK) model, using a recirculating system. Control kidneys were perfused with a substrate-enriched Ringer solution containing hydroxyethyl starch (HES) to produce isoncotic conditions. In the experimental group HES was substituted in part by UPPBHb1 (34 g/l). For determination of functional parameters, the kidneys were perfused for 180 min. A separate set of kidneys of both groups was perfusion fixed after 80 min of perfusion which is the period of optimal function. Light and electron microscopic analysis revealed major alterations only for the outer medulla of HES kidneys. Only these suffered from a considerable extent of proximal tubular S3 damage, exhibiting condensed tubular epithelia. In the inner stripe of the outer medulla, which is the zone of greatest sensitivity to damage in the isolated perfused kidney, severe hydropic degeneration, cell detachment, and necrotic destruction of the medullary thick ascending limb were seen in the HES-perfused group, too. In the UPPBHb1 group, the medullary thick ascending limb was well preserved, and S3 showed only a minor degree of damage. UPPBHB1 kidneys were further characterized by the occurrence of intracapillary and interstitial precipitates of UPPBHb1 in inner stripe of the outer medulla and inner medulla. The glomerular filtration rate was significantly higher in UPPBHb1-perfused kidneys (870 ± 80 vs. 630 ± 55 µl/min/g kidney weight for HES). Absolute reabsorption of sodium paralleled the behavior of the glomerular filtration rate. The values for renal perfusate flow and urinary flow rate did not differ significantly between both groups. Renal autoregulation was better preserved in UPPBHb1-perfused kidneys (74 ± 6% of full autoregulatory response) than in HES-perfused controls (42 ± 4%). Our results suggest that perfusion of isolated rat kidneys with UPPBHb1 improves kidney function and morphology, providing better oxygenation than in control kidneys. UPPBHb1 does not exert additional nephrotoxic effects on the IPRK that will exceed the noxious potential of the method itself. Thus, it must be concluded that UPPBHb1 may be an oxyphoretic blood substitute with nephroprotective characteristics when compared with nonoxyphoretic substitutes. At least, UPPBHb1 seems to be a promising candidate as oxyphoretic additive to perfusates for the IPRK model.

show abstract

“…[2][3][4][5] Phenazopyridine associated acute renal failure and AIN are rare but recognizable phenomena with phenazopyridine use in patients with renal dysfunction. 6,7 Few case reports have highlighted renal failure due to phenazopyridine overdose in patients with normal renal function [3][4][5][8][9][10][11][12][13][14][15][16][17][18] (Table 1). Various mechanisms have been postulated for phenazopyridine causing acute renal failure.…”

Section: Discussionmentioning

confidence: 99%

“…In rat models, phenazopyridine-induced methemoglobinemia has shown to cause interstitial edema, cast formation, tubular degeneration and regeneration. 1,3,9 Its overdose also causes dehydration, as a result of nausea and vomiting, leading to acute renal failure. 19 We hereby report biopsy proven case of AIN, solely related to phenazopyridine, without any evidence of methemoglobinemia or hemolytic anemia.…”

Section: Discussionmentioning

confidence: 99%

Phenazopyridine associated acute interstitial nephritis and review of literature

et al. 2014

View full text Add to dashboard Cite

Phenazopyridine is a urinary analgesic; commonly seen side-effects of this drug include, orange discoloration of urine, methemoglobinemia, yellowish skin discoloration, hepatitis and acute renal failure. Various case reports with phenazopyridine associated acute renal failure secondary to acute tubular necrosis have been reported in the literature. Acute kidney injury in these patients is caused by either direct injury to renal tubular epithelial cells or secondary to pigment induced nephropathy from hemolytic anemia. Hypoxic injury from phenazopyridineinduced methemoglobinemia has been well documented. We report a case of biopsy proven acute interstitial nephritis, associated with therapeutic doses of phenazopyridine without any evidence of methemoglobinemia or other mechanism of renal injury. Clinicians should be aware of the toxicity of this commonly used drug and should look closely for signs of renal insufficiency. Identifying and stopping the offending medication stays as the first step, but recent studies indicate that early steroid administration improves renal recovery, as well as decreasing the risk of progression to chronic kidney disease with fibrosis and consequent permanent renal damage.

show abstract

Methemoglobin-Induced Acute Renal Failure in the Rat

Cited by 74 publications

References 10 publications

Intrarenal Hemodynamics in Acute Myohemoglobinuric Renal Failure

Intrarenal Hemodynamics in Acute Myohemoglobinuric Renal Failure

Ultrapure Polymerized Bovine Hemoglobin Improves Structural and Functional Integrity of the Isolated Perfused Rat Kidney

Phenazopyridine associated acute interstitial nephritis and review of literature

Contact Info

Product

Resources

About