The influence of venous pressure on the isolated mammalian kidney

Winton, F. R.

doi:10.1113/jphysiol.1931.sp002761

Cited by 249 publications

(172 citation statements)

References 2 publications

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“…Animal studies have consistently shown that increasing renal venous pressure by approximately 20-25 mmHg in the isolated dog or rat kidneys caused a profound decrease in renal perfusion accompanied by a sharp drop in the GFR, sodium excretion, and urine flow. Renal function promptly returned to normal when the venous pressure was lowered (37,42).…”

Section: Role Of High Venous Pressure In the Pathogenesis Of Crsmentioning

confidence: 99%

Cardiorenal Syndrome

Anand

2013

Clinical Journal of the American Society of Nephrology

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Summary The cardiorenal syndrome has recently been defined as “disorders of the heart and kidney whereby acute or chronic dysfunction in one organ may induce acute or chronic dysfunction of the other.” The syndrome is extremely common and independently associated with poor clinical outcomes. However, no pharmacological therapy has been shown to improve its outcomes. Unfortunately, the mechanisms that initiate the development of renal dysfunction in heart failure are still debated. This review tries to clarify some of the misunderstanding regarding the principle hemodynamic factors that drive the kidneys to retain salt and water.

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Section: Role Of High Venous Pressure In the Pathogenesis Of Crsmentioning

confidence: 99%

Cardiorenal Syndrome

Anand

2013

Clinical Journal of the American Society of Nephrology

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“…Edema, positive fluid balance, and/or high central venous pressure have been shown in human and/or experimental models to have a negative impact on biological processes, including microvascular perfusion, renal perfusion, sodium and water excretion, intraabdominal pressure, cardiac function, and pulmonary gas exchange (31)(32)(33)(34)(35)(36). Intestinal edema and edema of the skin may contribute to impaired epithelial integrity and risk of bacterial translocation and/or infection (37).…”

Section: Comparison With Previous Studiesmentioning

confidence: 99%

Volume Overload: Prevalence, Risk Factors, and Functional Outcome in Survivors of Septic Shock

et al. 2015

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Rationale: Survivors of septic shock have impaired functional status. Volume overload is associated with poor outcomes in patients with septic shock, but the impact of volume overload on functional outcome and discharge destination of survivors is unknown.Objectives: This study describes patterns of fluid management both during and after septic shock. We examined factors associated with volume overload upon intensive care unit (ICU) discharge. We then examined associations between volume overload upon ICU discharge, mobility limitation, and discharge to a healthcare facility in septic shock survivors, with the hypothesis that volume overload is associated with increased odds of these outcomes. Methods:We retrospectively reviewed the medical records of 247 patients admitted with septic shock to an academic county hospital between June 2009 and April 2012 who survived to ICU discharge. We defined volume overload as a fluid balance expected to increase the subject's admission weight by 10%. Statistical methods included unadjusted analyses and multivariable logistic regression.Measurements and Main Results: Eighty-six percent of patients had a positive fluid balance, and 35% had volume overload upon ICU discharge. Factors associated with volume overload in unadjusted analyses included more severe illness, cirrhosis, blood transfusion during shock, and higher volumes of fluid administration both during and after shock. Blood transfusion during shock was independently associated with increased odds of volume overload (odds ratio [OR], 2.65; 95% confidence interval [CI], 1.33-5.27; P = 0.01) after adjusting for preexisting conditions and severity of illness. Only 42% of patients received at least one dose of a diuretic during their hospitalization. Volume overload upon ICU discharge was independently associated with inability to ambulate upon hospital discharge (OR, 2.29; 95% CI, 1.24-4.25; P = 0.01) and, in patients admitted from home, upon discharge to a healthcare facility (OR, 2.34; 95% CI, 1.1-4.98; P = 0.03).Conclusions: Volume overload is independently associated with impaired mobility and discharge to a healthcare facility in survivors of septic shock. Prevention and treatment of volume overload in patients with septic shock warrants further investigation.

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“…It is sufficient to point out here that the kidney will indeed form urine even though the renal venous pressure is raised to 30 ram. Hg (12).…”

Section: Discussionmentioning

confidence: 99%

The Intrarenal Pressure

Montgomery

Davis

Prine

et al. 1950

Journal of Experimental Medicine

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By the use of a new method for measuring the intrarenal pressure, we have shown it to be about 26 ram. Hg in deeerebrate dogs (1, 2). I t is the purpose of the present report to amplify this series and also to give data obtained on unanesthetized normal dogs and on dogs under sodium pentobarbital anesthesia. The relation between the intrarenal pressure and the age, weight, blood pressure, and sex of the dogs was also ascertained. A few measurements of the I R P in cats, rabbits, and rats will also be reported. MethodsThe intrarenal pressure is measured (2) by thrusting deep into the medulla of the kidney a perforated 20-gauge needle, which is connected with a manometer. 250 ram. Hg is then suddenly imposed on the system. The elasticity of the manometer, etc., rapidly forces a small amount (about 10 c. ram.) of saline-heparin into the kidney until equilibrium is reached with the pressure of fluids in the kidney tissue. The pressure changes are recorded; when no further change in pressure is registered, this is the objective measurement of intrarenal pressure (to be abbreviated henceforth as IRP).The IRP was measured three times in each dog, the mean of the three measurements being given in these data. Readings were taken immediately after the kidney was exposed with care to avoid manipulation of the kidney and trauma. Systolic and diastolic blood pressures were taken simultaneously by optical means with a glass Bourdon tube (3, 4), after cannulation of the femoral or carotid artery. Dogs 1 year old or over were used, the age being estimated from the teeth wear by Boeuish's (5) method. The decerebrated dogs were prepared as described by Fee (6); the IRP of these animals was taken after the animal had breathed off the ether employed during the surgical procedure, at a time when the animal's spinal reflexes had returned. In the experiments with unanesthetized dogs, explantation of the kidney to a subcutaneous position in the flank, with excision of the eontralateral kidney was accomplished, following in general the technic of Rhoads (7). About 15 days afterwards, observations of IRP were taken. With the kidney explanted, measurements of IRP were readily taken by thrusting the needle through the skin and into the kidney. The dogs were trained to lie still; they were neither hurt nor excited during the procedure.In order to determine whether different species of animals would have the same magnitude of IRP as dogs, measurements were also made on cats, rabbits, and rats. All were anesthetized with sodium pentobarbltal.

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The influence of venous pressure on the isolated mammalian kidney

Cited by 249 publications

References 2 publications

Cardiorenal Syndrome

Cardiorenal Syndrome

Volume Overload: Prevalence, Risk Factors, and Functional Outcome in Survivors of Septic Shock

The Intrarenal Pressure

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