Document Detail

Renal water and sodium handling during gradated unilateral ureter obstruction.
MedLine Citation:
PMID:  12201929     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: Unilateral complete obstruction of the ureter (UUO) is associated with characteristic changes in renal function. To improve the understanding of how urine concentration directly is affected by changes in pelvic pressure, changes in renal salt and water handling along the nephron and collecting duct were examined. MATERIAL AND METHODS: Pelvic pressure was raised stepwise using an adjustable lever inserted in the right ureter. Urine samples were collected from the tip of the catheter by way of an overflow system. Water and sodium handling in the distal and proximal tubules were measured by the lithium clearance technique. Renal blood flow (RBF) was measured with implanted ultrasonic flow probes. Catheters were placed in both renal veins and glomerular filtration rate (GFR) and filtration fraction were calculated using renal extraction of (51)Cr-EDTA independent of urine sampling. RESULTS: The sequence of changes for each parameter is provided. The parameters did not show a uniform pattern from which specific threshold values could be derived. However, the mean value of the following parameters were markedly changed at specific pressures: (1) at 10 cm H(2)O ipsilateral urine output decreased rapidly and distal absolute reabsorption of sodium (DAR(H2O)) decreased, (2) at 20 cm H(2)O GFR started to decline rapidly, (3) at 30 cm H(2)O urine output was impaired, and (4) at 40 cm H(2)O proximal absolute reabsorption of water (PAR(H2O)) showed a decreasing tendency in all pigs together with impairment in tubular sodium handling. Furthermore, free water clearance was slightly impaired (-0.26 +/- 0.15 at baseline and -0.15 +/- 0.08 ml/min at maximum pressure) and ipsilateral RBF decreased from 171.1 +/- 12.4 ml/min at baseline to 136.3 +/- 12.3 ml/min at ureteral pressure of 80 cm H(2)O (p < 0.05). Consistent with that, ipsilateral renal vascular resistance increased with increasing pressure in the renal pelvis. CONCLUSION: Water reabsorption and sodium handling is progressively impaired with increasing pelvic pressure. GFR and RBF are reduced in parallel. The study shows that the kidney responds to ureteral obstruction is unique and individual.
T S Pedersen; J J Hvistendahl; J C Djurhuus; J Frøkiaer
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Scandinavian journal of urology and nephrology     Volume:  36     ISSN:  0036-5599     ISO Abbreviation:  Scand. J. Urol. Nephrol.     Publication Date:  2002  
Date Detail:
Created Date:  2002-08-30     Completed Date:  2002-10-08     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0114501     Medline TA:  Scand J Urol Nephrol     Country:  Sweden    
Other Details:
Languages:  eng     Pagination:  163-72     Citation Subset:  IM    
Institute of Experimental Clinical Research, University of Aarhus, Aarhus University Hospital, Skejby, Aarhus N, Denmark.
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MeSH Terms
Body Water / metabolism*
Glomerular Filtration Rate
Kidney / physiopathology*
Kidney Tubules / physiology
Renal Circulation
Sodium / metabolism*
Ureteral Obstruction / physiopathology*
Vascular Resistance
Reg. No./Substance:

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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