Renal Clearance Tests of Various Congenital Heart Diseases in Childhood

Matsuyama, S; Hayashi, M; Takarada, Masahata

doi:10.1111/j.1442-200x.1965.tb01432.x

Cited by 2 publications

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“…Previous studies have found abnormalities in effective renal plasma flow in children with congenital heart disease [24,41,45,461, and found that medullary necrosis in infants and changes in C,,,, in newly born piglets may occur after administration of angiographic media [23]; accordingly, investigations relative to these problems were performed. In addition, measurements of RBF were obtained in six kidneys judged to be normal.…”

Section: Zntroclz~ctionmentioning

confidence: 99%

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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: Zntroclz~ctionmentioning

confidence: 99%

“…Decreased renal plasma flow in children with both cyanotic and acyanotic CHD has been demonstrated by a number oi investigators using the PAH clearance technique [24,41,45,461. Although the GFR is usually normal, some patients have had reduced levels of GFR in the absence of heart failure.…”

Section: Renail Blood Flow In Chdmentioning

confidence: 99%