Renal Venous Pressure in Chronic Congestive Heart Failure 1

Maxwell, Morton H.; Breed, Ernest S.; Schwartz, Irving L.

doi:10.1172/jci102263

Cited by 116 publications

(50 citation statements)

References 13 publications

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“…those patients with the largest arteriovenous com-These values were not changed significantly by munications, as estimated by the surgeon at the surgical repair of the fistula. Acute occlusion and time of operation, demonstrated the most marked release of an arteriovenous shunt produced no Hg) (14) and was unaltered by temporary closure or opening of the arteriovenous fistula.…”

Section: Methodsmentioning

confidence: 97%

The Effect of an Arteriovenous Fistula on Renal Hemodynamics and Electrolyte Excretion 1

Epstein¹,

Post²,

McDowell³

1953

J. Clin. Invest.

122

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Section: Methodsmentioning

confidence: 97%

The Effect of an Arteriovenous Fistula on Renal Hemodynamics and Electrolyte Excretion 1

Epstein¹,

Post²,

McDowell³

1953

J. Clin. Invest.

122

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“…Both parameters are reflections of cardiac status and are mutually associated. Renal venous pressure is closely related to RBF in certain pathophysiological states, such as CHF [11]. Therefore, it is to be expected that it influences GFR.…”

Section: Independent Component Of Venous Congestion In Pathophysiologmentioning

confidence: 99%

Decreased cardiac output, venous congestion and the association with renal impairment in patients with cardiac dysfunction

Damman

Navis

Smilde

et al. 2007

European J of Heart Fail

422

291

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Background: Renal failure in heart failure is related to decreased cardiac output. However, little is known about its association with venous congestion. Aims: To investigate the relationship between venous congestion and glomerular filtration rate (GFR) in patients with cardiac dysfunction. Methods and results: Right atrial pressure (RAP) and cardiac index (CI) were determined by right heart catheterisation in 51 patients with cardiac dysfunction, secondary to pulmonary hypertension. GFR and renal blood flow (RBF) were measured as 125 I-Iothalamate and 131 IHippuran clearances, respectively. Mean age was 40 ± 11 years and 69% of patients were female. GFR was 73 ± 19 ml/min/1.73 m 2 with a CI of 2.1 ± 0.7 l/min/m 2 . In multivariate analysis, RBF (r = 0.664, p b 0.001) and RAP (r = − 0.367, p = 0.020) were independently associated with GFR. In patients in the lower ranges of RBF, venous congestion was an important determinant of renal function. Conclusion: RBF is the main factor determining GFR in patients with cardiac dysfunction. Venous congestion, characterised by an increased RAP, adjusted for RBF is also related to GFR. Treatment to preserve GFR should not only focus on improvement of renal perfusion, but also on decreasing venous congestion.

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“…A catheter was passed via the right jugular vein into the left renal vein and placed so that its tip lay distal to the clamp. This catheter was connected to a water manometer allowing continuous 1 This work was made possible by grants-in-aid from the New York Heart Association and the American Heart Association.…”

Section: Methodsmentioning

confidence: 99%

“…Since such patients, without any intrinsic renal disease, frequently have both an elevated renal venous pressure and a reduced renal blood flow (1), it would seem that either one or both of these factors may lead to proteinuria.…”

mentioning

confidence: 99%

The Pathogenesis of Proteinuria in the Acutely Congested Kidney 1

Wégria¹,

Capeci²,

Blumenthal³

et al. 1955

J. Clin. Invest.

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The appearance of proteinuria in patients suffering from congestive heart failure is a common clinical occurrence. Since such patients, without any intrinsic renal disease, frequently have both an elevated renal venous pressure and a reduced renal blood flow (1), it would seem that either one or both of these factors may lead to proteinuria.Proteinuria has been produced experimentally by partial obstruction either of the renal artery or of the renal vein (2-5). In most of this work, however, studies of renal hemodynamics were incomplete, or when adequate pressure and blood flow measurements were made (6, 7), the experiments were such that it was impossible to determine specifically which hemodynamic factor was responsible for the appearance of the proteinuria.The present study was The estimations of renal plasma flow (RPF) and glomerular filtration rate (GFR) for each kidney were made by determining the clearances of para-aminohippurate (PAH) and exogenous creatinine, respectively. Blood samples were drawn at the midpoint of each clearance period from the right femoral artery through an indwelling needle. During the operative procedure the animal was given intravenously a priming d.nse of 1.5 grams of creatinine dissolved in 30 ml. of water. This was followed by a sustaining infusion of an 0.85 per cent NaCl solution delivered at a constant rate of 3 or 5 ml. per minute by a Bowman Pump for the remainder of the experiment. This sustaining infusion contained sufficient amoants of creatinine and PAH so that these substances were delivered at rates of 20 mg. of creatinine per minute and 3 mg. of PAH per minute. In some instances an additional infusion of NaCl solution (0.85 or 1.5 per cent) was given during the course of the experiment. The reason for this will be discussed later.After completion of the operative procedure the animal was allowed to recover for about 30 minutes. One or more control urine samples were then collected in order to measure the clearances and determine the presence of proteinuria. The clamp was then tightened until the pressure in the left renal vein rose to the desired level. After the pressure had been elevated for 15 to 30 minutes, con-secutive urine samples were collected until proteinuria appeared or until the pressure had been elevated for 1 to approximately 3 hours without the occurrence of proteinuria. The clamp was then released allowing the pressure in the left renal vein to fall freely.After an interval of time at least sufficient to allow the renal dead space to be cleared, one or more recovery samples were collected.Creatinine concentration in urine and plasma was determined by the method of Kennedy, Hilton, and Berliner (9). PAH concentration in urine and plasma was determined by the method of Smith, Finkelstein, Aliminosa, Crawford, and Graber (10).The method used to determine the concentration of protein in urine was a modification of the method of 737

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Renal Venous Pressure in Chronic Congestive Heart Failure 1

Cited by 116 publications

References 13 publications

The Effect of an Arteriovenous Fistula on Renal Hemodynamics and Electrolyte Excretion 1

The Effect of an Arteriovenous Fistula on Renal Hemodynamics and Electrolyte Excretion 1

Decreased cardiac output, venous congestion and the association with renal impairment in patients with cardiac dysfunction

The Pathogenesis of Proteinuria in the Acutely Congested Kidney 1

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