What is Intrarenal vasoconstriction?
Intrarenal vasoconstriction is the dominant mechanism for reduced GFR in patients with ATN. The mediators of this vasoconstriction are unknown, but tubular injury seems to be an important concomitant finding.
Which drugs cause intrarenal vasoconstriction?
Background: Cyclosporine causes intrarenal vasoconstriction, which may account for its nephrotoxic side effects. Plasma levels of the vasoconstrictor peptide endothelin-1 are increased after cyclosporine administration, and endothelin-1 has been shown to cause renal vasoconstriction.
What is Intrarenal azotemia?
Intrarenal azotemia. Intrarenal azotemia, also known as acute kidney injury (AKI), renal-renal azotemia, and (in the past) acute renal failure (ARF), refers to elevations in BUN and creatinine resulting from problems in the kidney itself.
How does ischemia cause vasoconstriction?
Glomerulotubular Dysfunction and Acute Kidney Injury Renal ischemia results in the depletion of cellular adenine nucleotides and increased levels of adenosine, an agent implicated as a mediator of local renal vasoconstriction.
How does renal blood flow affect GFR?
Because renal blood flow and GFR normally change in parallel, any increase in renal blood flow causes an increase in GFR. The increased renal O2 consumption (GFR) is offset by an increase in renal oxygen delivery (renal blood flow). This results in a constant arteriovenous O2 difference across the kidney.
What is the difference between Prerenal Intrarenal and Postrenal?
Pre-renal, generally in which decreased renal blood flow results in a drop in GFR. Intrinsic/intra-renal, in which a disease process causes damage to the kidney itself. Post-renal, in which a process downstream of the kidney prevents drainage of urine (urinary tract obstruction)
What is a Intrarenal stone?
Reviewed on 3/29/2021. Renal stone: A stone in the kidney (or lower down in the urinary tract). Also called a kidney stone. Renal stones are a common cause of blood in the urine and pain in the abdomen, flank, or groin. Kidney stones occur in 1 in 20 people at some time in their life.
What’s the difference between oliguria and anuria?
Oliguria occurs when the urine output in an infant is less than 0.5 mL/kg per hour for 24 hours or is less than 500 mL/1.73 m2 per day in older children. Anuria is defined as absence of any urine output.
Does hyperchloremia cause vasoconstriction in the kidneys?
In conclusion, hyperchloremia produces a progressive renal vasoconstriction and fall in GFR that is independent of the renal nerves, is potentiated by prior salt depletion and is related to tubular Cl(-) reabsorption. Chloride-induced vasoconstriction appears specific for the renal vessels.
Do the effects of hyperchloremia influence outcome?
Thus, we suspect that the effects of hyperchloremia, especially when modest, are unlikely to influence outcome for most patients. However, given that hyperchloremic acidosis is often iatrogenic, and associated with morbidity, it should be avoided whenever possible.
Is hyperchloremic metabolic acidosis a necessary evil?
Historically, hyperchloremic metabolic acidosis has been viewed as a ‘necessary evil’ of volume resuscitation in critically ill patients. Dr Eisenhut has appropriately included several studies published in the past 10 years highlighting some of the adverse effects of this iatrogenic hyperchloremia [2–7].
What is the relationship between isotonic saline and hyperchloremic acidosis?
Two-thirds of patients in the isotonic saline group but none in the balanced fluid group developed hyperchloremic metabolic acidosis [ 3 ]. The hyperchloremic acidosis was associated with reduced gastric mucosal perfusion on gastric tonometry.