Thiosulphate Clearance in Pregnancy

Lambiotte, C; Blanchard, Joseph; Graff, Samuel; Graff, Ada M.

doi:10.1172/jci102358

Cited by 22 publications

(2 citation statements)

References 11 publications

(11 reference statements)

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“…The urate appearinig in the urinie is considered to represent that 5 to 10 per cent of the filtered urate load which has escaped reabsorption ( Figure 4). Another possible interpretation, also consistent with the clearance data, considers tubular reabsorption of the filtered urate to be virtually complete under ordinary circumstances, and the urinary urate to be derived by tubular excretion (7,32,33) (Figure 4), i.e., a mechainism similar to that postulated for potassium (34,35) fate (36). The processes of tubular reabsorption and excretion of urate both are conceived to be chiefly "active," in view of their limited capacity and the inhibiting effects of a variety of chemical agents.…”

Section: Mechanisms Of Renal Excretion Of Salicylate In Mansupporting

confidence: 63%

Study of the Paradoxical Effects of Salicylate in Low, Intermediate and High Dosage on the Renal Mechanisms for Excretion of Urate in Man *

Yu¹,

Gutman²

1959

J. Clin. Invest.

193

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Salicylate administered to man in sufficiently large dosage (5 to 6 or more Gm. per day) causes marked uricosuria, characterized by substantially increased urate/inulin clearance ratios attributable to inhibition of tubular reabsorption of the filtered urate. In smaller dosage (1 to 2 Gm. per day) salicylate exerts a contrary effect, retention of urate, associated with lower than normal urate/inulin clearance ratios (1-8). When small doses of salicylate are given concurrently with probenecid, the retention of urate caused by the salicylate is sufficiently pronounced to counteract, to a marked degree, the uricosuric effect of the probenecid (9, 10). Phenylbutazone and phenylbutazone metabolite I similarly cause marked retention of urate when administered in low dosage (7), and are uricosuric in large dosage.Two explanations of this paradoxical effect have been offered (5,7,8). It is conceivable that the tubular transport system effecting reabsorption of urate might be stimulated by small doses and suppressed by larger doses of the drugs in question. Or, a postulated tubular excretory mechanism for urate (not apparent in the usual clearance measurements in man) might be inhibited by small doses, thus causing urate retention; and when larger doses are given tubular reabsorption of urate also is suppressed, the net effect then being uricosuric.The present study documents the paradoxical action of salicylate by providing more detailed data on the effect of small, intermediate and large doses on the 24 hour urinary urate excretion, using analytical methods incorporating precautions to obviate errors due to the presence of a salicylate metabolite, gentisic acid. The relationships between the renal excretion of salicylate and of urate are then examined by means of simultaneous clearance techniques, including studies under conditions of urine pH made to vary from markedly acid to markedly alkaline. Clearance data on the antagonistic effect of small doses of salicylate on probenecid uricosuria, and vice versa, also are presented. Finally, the implications of the results as a whole are considered in relation to current concepts of renal mechanisms for the excretion of salicylate and of urate, with special reference to inferences regarding the possibility of tubular excretion of urate in man. METHODSThe subjects selected for investigation were all adult, gouty males, in the intercritical phase of the disorder. Forty-four studies were made in 23 of these subjects to determine the effect of orally administered acetylsalicylic acid, in divided doses totaling 1.0, 2.0, 3.0 and 5.2 Gm. per day, respectively, on the 24 hour urinary urate excretion and the serum urate level. All subjects were maintained on a constant diet low in purines and restricted in protein (60 to 75 Gm. per day) for at least three days preceding study. Twenty-four hour collections of urine were then made for eight or 12 days, blood samples being secured at appropriate intervals. After a four day control period, the patient received the prescribed daily medic...

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Section: Mechanisms Of Renal Excretion Of Salicylate In Mansupporting

confidence: 63%

Study of the Paradoxical Effects of Salicylate in Low, Intermediate and High Dosage on the Renal Mechanisms for Excretion of Urate in Man *

Yu¹,

Gutman²

1959

J. Clin. Invest.

193

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“…Inulin in serum and urine was determined by method of Roe, Epstein, and Goldstein (21) (20). terms of optical density was derived.…”

Section: Renal Function Studiesmentioning

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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Assessment of Renal Function; Clearance, the Renal Microcirculation, Renal Blood Flow, and Metabolic Balance

Beierwaltes

Harrison‐Bernard

Sullivan

et al. 2013

Comprehensive Physiology

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Historically, tools to assess renal function have been developed to investigate the physiology of the kidney in an experimental setting, and certain of these techniques have utility in evaluating renal function in the clinical setting. The following work will survey a spectrum of these tools, their applications and limitations in four general sections. The first is clearance, including evaluation of exogenous and endogenous markers for determining glomerular filtration rate, the adaptation of estimated glomerular filtration rate in the clinical arena, and additional clearance techniques to assess various other parameters of renal function. The second section deals with in vivo and in vitro approaches to the study of the renal microvasculature. This section surveys a number of experimental techniques including corticotomy, the hydronephrotic kidney, vascular casting, intravital charge coupled device videomicroscopy, multiphoton fluorescent microscopy, synchrotron-based angiography, laser speckle contrast imaging, isolated renal microvessels, and the perfused juxtamedullary nephron microvasculature. The third section addresses in vivo and in vitro approaches to the study of renal blood flow. These include ultrasonic flowmetry, laser-Doppler flowmetry, magnetic resonance imaging (MRI), phase contrast MRI, cine phase contrast MRI, dynamic contrast-enhanced MRI, blood oxygen level dependent MRI, arterial spin labeling MRI, x-ray computed tomography, and positron emission tomography. The final section addresses the methodologies of metabolic balance studies. These are described for humans, large experimental animals as well as for rodents. Overall, the various in vitro and in vivo topics and applications to evaluate renal function should provide a guide for the investigator or physician to understand and to implement the techniques in the laboratory or clinic setting.

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Thiosulphate Clearance in Pregnancy

Cited by 22 publications

References 11 publications

Study of the Paradoxical Effects of Salicylate in Low, Intermediate and High Dosage on the Renal Mechanisms for Excretion of Urate in Man *

Study of the Paradoxical Effects of Salicylate in Low, Intermediate and High Dosage on the Renal Mechanisms for Excretion of Urate in Man *

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

Assessment of Renal Function; Clearance, the Renal Microcirculation, Renal Blood Flow, and Metabolic Balance

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