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Fractional Excretion of Sodium

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1601. Effects of amlodipine on renal haemodynamics in mild to moderate hypertensive patients. A randomized controlled study versus placebo. (Abstract)

vascular resistance (RVR = MBP x 80/ERBF) were calculated. Plasma renin activity (PRA), serum aldosterone (ALD) and urinary excretion of sodium (NaU) were evaluated. At the end of amlodipine administration a significant decrease (P < 0.001) in SBP, DBP and MBP from baseline values was observed. A significant decrease (P < 0.01) in RVR and significant increases (P < 0.05) in ERPF, ERBF and in NaU were also found, without relevant changes in GFR, FF, PRA and ALD. No significant variation in clinical (...) cardiac or renal diseases were randomly allocated to a double-blind 4 weeks controlled study with amlodipine 10 mg once a day (15 patients) or placebo (15 patients). Renal haemodynamic measurements included effective renal plasma flow (ERPF) and glomerular filtration rate (GFR) by radionuclide study using 131I-hippuran and 99mTc, with methods described by Schlegel and Gates, respectively. In addition, effective renal blood flow [ERBF = ERPF/(1-Ht)], filtration fraction (FF = GFR/ERPF) and renal

1993 European journal of clinical pharmacology Controlled trial quality: uncertain

1602. The acute haemodynamic and renal effects of oral felodipine and ramipril in healthy subjects. (Abstract)

resistance (FVR), renal blood flow (RBF), renal vascular resistance (RVR), glomerular filtration rate (GFR), filtration fraction (FF), diuresis, and sodium excretion were recorded for 4.75 h after administration. Felodipine 20 mg caused a significant fall in diastolic blood pressure, maximal 12% compared with placebo, while there were no significant effects of felodipine 5 mg or the two doses of ramipril. Heart rate increased significantly after both doses of felodipine, maximal 28% after the 20 mg dose

1993 European journal of clinical pharmacology Controlled trial quality: uncertain

1603. Effect of ketoprofen on blood pressure, endocrine and renal responses to chronic dosing with captopril in patients with essential hypertension. (Abstract)

, between ketoprofen and placebo were 4 (95% confidence intervals -5, +13) and 0 (-8, +8) mmHg, respectively. Ketoprofen had no effect on 24-h urinary sodium excretion (160 +/- 33 and 147 +/- 39 mmol/24 h for ketoprofen and placebo, respectively). Ketoprofen was without effect on glomerular filtration rate, renal plasma flow and filtration fraction. In conclusion, our data suggest that ketoprofen is a safe choice when short-term treatment with a NSAID is indicated in an essential hypertensive patient

1992 Blood pressure Controlled trial quality: uncertain

1604. Effect of dopamine on failure of indomethacin to close the patent ductus arteriosus. (Abstract)

characteristics. Serum creatinine concentrations, urine output, and fractional excretion of sodium were not different in the three groups after indomethacin treatment. Two patients receiving placebo required a second course of indomethacin compared with four patients in the low-dopamine group and one in the high-dopamine group. The proportion of failures of medical treatment was not statistically different among the three groups. We conclude that concomitant dopamine therapy neither decreases the failure rate

1992 The Journal of pediatrics Controlled trial quality: uncertain

1605. Treatment of intraoperative hypertension with enflurane, nicardipine, or human atrial natriuretic peptide: haemodynamic and renal effects. Full Text available with Trip Pro

phosphate (PO4). Hypertension during gastrectomy was treated by increasing the concentration of enflurane, by nicardipine infusion (0.5-2.0 micrograms.kg-1 x min-1), or by hANP infusion (0.05-0.2 microgram.kg-1 x min-1) under general anaesthesia. Enflurane, nicardipine and hANP all decreased arterial pressure to the same extent. Urine flow, Na and PO4 excretion increased following the administration of nicardipine or hANP. Fractional distal reabsorption of sodium was suppressed from 89.7 +/- 2.8 (...) Treatment of intraoperative hypertension with enflurane, nicardipine, or human atrial natriuretic peptide: haemodynamic and renal effects. The purpose of this study was to assess the effects of the calcium entry blocker nicardipine and alpha human atrial natriuretic peptide (hANP) on antihypertensive and diuretic activity in hypertensive surgical patients. The site of the diuretic actions of these drugs along the nephron were also investigated by measuring the excretion rate of inorganic

1992 Canadian journal of anaesthesia = Journal canadien d'anesthesie Controlled trial quality: uncertain

1606. Renal function and cardiopulmonary bypass: effect of perfusion pressure. (Abstract)

into two groups: group 1 included 14 patients whose arterial blood pressure during CPB was left untreated, and group 2 consisted of 7 patients who received phenylephrine to maintain their arterial pressure above 70 mmHg. Plasma and urine creatinine, sodium, potassium, and osmolality were measured preoperatively, intraoperatively and postoperatively. Creatinine, osmolal and free water clearances, and excreted sodium fraction were calculated. Plasma creatinine remained normal throughout the study in all

1992 Journal of cardiothoracic and vascular anesthesia Controlled trial quality: uncertain

1607. Dose-response study of atrial natriuretic peptide bolus injection in healthy man. (Abstract)

bolus injection to five different groups. GFR rose after ANP, whereas no immediate change in RPF was observed. Significant increases with no distinct additional effect of ANP doses higher than 1.0 microgram kg-1 were detected in filtration fraction, urinary flow rate and urinary excretion rate of sodium. Both proximal and distal fractional reabsorption of sodium was reduced and the effect seemed to flatten out at doses higher than 1.0 microgram kg-1. Dose-dependent increases in cyclic guanosine (...) were observed with higher doses despite dose-dependent increases in urinary cGMP excretion and plasma cGMP. Inhibition of both proximal and distal tubular fractional sodium reabsorption by ANP contributed to the natriuretic effect.(ABSTRACT TRUNCATED AT 250 WORDS)

1993 European journal of clinical investigation Controlled trial quality: uncertain

1608. Antinatriuretic action of insulin is preserved after angiotensin I converting enzyme inhibition in normal man. (Abstract)

before each study as an indirect marker of tubular sodium handling. Renal haemodynamics did not change during hyperinsulinaemia. Insulin infusion reduced both the absolute and fractional urinary excretion rates of sodium (P < 0.001) and potassium (P < 0.001); these effects of insulin were not altered after converting enzyme inhibition. Lithium clearance did not change during insulin infusion on either day. The antinatriuretic effect of hyperinsulinaemia is mediated at a tubular site distal

1993 Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association Controlled trial quality: uncertain

1609. Acute effects of physiological increments of alpha-atrial natriuretic peptide in man. (Abstract)

. Ve). Plasma aldosterone was unaltered by h-alpha ANP. Fractional excretion of filtered sodium (FENa) changed from 0.92 +/- 0.09 to 1.13 +/- 0.16% with h-alpha ANP, and from 1.02 +/- 0.09 to 0.69 +/- 0.11% with Ve (P less than 0.01 h-alpha ANP vs. Ve). FEK was unchanged. FEpo4 increased from 7.2 +/- 1.2 to 9.2 +/- 1.2% and FELi from 22.1 +/- 1.4 to 24.9 +/- 3.0% with h-alpha ANP (both P less than 0.05 vs. Ve). H-alpha ANP decreased mean urinary osmolality by approximately 150 mOsmol kg-1 compared (...) to Ve (P less than 0.01). GFR, RPF and filtration fraction were unchanged by h-alpha ANP, H-alpha ANP was associated with a significant tachycardia (P less than 0.01 vs. Ve) but with no significant change in arterial pressure. These results suggest that small increments of plasma h-alpha ANP, mimicking physiological changes, are natriuretic at least partly by reducing proximal tubular reabsorption of sodium, and also impair urinary concentration.

1989 Kidney international Controlled trial quality: uncertain

1610. Effects of penbutolol on plasma atrial natriuretic peptide and antidiuretic hormone levels before and after exercise: a double-blind comparison against placebo. (Abstract)

suppression of the exercise-induced increase in ANP. The 2 to 4 hour fractional sodium excretion was significantly decreased from 12.1 +/- 4.9 mmol/fraction after placebo treatment to 7.8 +/- 3.0 mmol/fraction after penbutolol application (p less than 0.03). There were no differences in the urinary outputs between penbutolol and placebo until 4 hours after medication, but penbutolol caused the total urinary output to increase from 1390 +/- 388 ml/24 hr during placebo treatment to 1725 +/- 549 ml/24 hr (p (...) the application of test medications. Ergometric exercises were performed before medication, and at 2, 5, 9 and 24 hours after medication. Blood samples for ANP and ADH levels were drawn before, after 15 min, after 2 hours (immediately after ergometry) and 5, 7, 9, and 24 hours after medication (immediately before ergometry). Urine was collected as follows: -2 to 0, 0 to 2, 2 to 4, 4 to 7, 7 to 14 and 14 to 24 hours after medication, and the volume as well as sodium excretion were documented. Penbutolol caused

1989 Pharmatherapeutica Controlled trial quality: uncertain

1611. The effect of carbidopa and lithium on the systemic and renal response to acute intravenous saline loading in normal man. (Abstract)

The effect of carbidopa and lithium on the systemic and renal response to acute intravenous saline loading in normal man. To assess a possible role for endogenous renal dopamine in sodium excretion, the dopa decarboxylase inhibitor carbidopa was given during intravenous salt loading. In addition, the effect of lithium on tubular sodium handling was separately determined. Nine males were studied randomly on three occasions, receiving placebo, lithium carbonate (1000 mg, 11 h prior to study (...) was comparable to values on placebo at all time points. Fractional lithium clearance, a proposed measure of proximal tubular fluid rejection, increased significantly during saline infusion. However, baseline sodium excretion was greater in the presence of lithium, and plasma renin activity (PRA) was significantly elevated. In addition, the peak natriuretic response was smaller and cumulative sodium excretion reduced by 40% (P less than 0.01) compared to placebo. This study provides no evidence

1989 Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association Controlled trial quality: uncertain

1612. Mechanisms of the antinatriuretic action of physiological doses of angiotensin II in man. (Abstract)

excretion (113 +/- 13 to 82 +/- 10 mumol/min). This antinatriuretic effect occurred without a fall in creatinine clearance (107 +/- 3 versus 113 +/- 3 ml/min). 4. ANG II caused a significant fall in fractional lithium clearance (28 +/- 2 to 23 +/- 2%). This may indicate a proximal tubular effect of ANG II. 5. ANG II also reduced fractional distal delivery [(sodium clearance plus free water clearance) divided by creatinine clearance], another measure of proximal tubular outflow. A parallel change (...) in these two separate markers of proximal function supports an action of ANG II at this nephron segment. 6. Furthermore, the antinatriuretic effect of ANG II was unlikely to be due to stimulation of aldosterone secretion because (a) the fall in sodium excretion was temporally dissociated from the rise in aldosterone secretion, (b) potassium excretion also tended to fall during ANG II infusion and (c) aldosterone has a distal nephron effect, while, in this study, proximal nephron fractional reabsorption

1989 Clinical science (London, England : 1979) Controlled trial quality: uncertain

1613. Acute hemodynamic (systemic and renal) and humoral effects of three increasing doses of iloprost in essential hypertensives. (Abstract)

for 45 min) in a single-blind randomized sequence. Each dose was preceded by placebo (saline infusion for 45 min) with a 48 h interval between each study. Iloprost significantly (P less than .05) reduced blood pressure, and increased heart rate, filtered sodium, urinary sodium excretion, fractional sodium excretion, noradrenaline, adrenaline, and plasma renin activity (PRA). The blood pressure lowering effect as well as the heart rate, renal plasma flow and noradrenaline increases were significantly (...) greater on the 4 ng dose. Glomerular filtration rate and adrenaline showed a dose-dependent increase; urinary sodium excretion and fractional sodium excretion were similarly increased by the three doses. No correlation was found between urinary sodium excretion and either glomerular filtration rate or renal plasma flow. The data obtained indicate that Iloprost causes reduction of blood pressure with a reflex activation in the sympathetic nervous system and stimulation of renin secretion, renal

1989 American journal of hypertension Controlled trial quality: uncertain

1614. Mechanism of impaired natriuretic response to furosemide during prolonged therapy. (Abstract)

Mechanism of impaired natriuretic response to furosemide during prolonged therapy. The mechanism of the diuretic braking phenomenon was studied in nine male hypertensive patients by assessing the diurnal pattern of renal sodium (Na) excretion during furosemide therapy, and the response to a test dose of furosemide (10 to 15 mg hr-1 i.v.) infused alone and with chlorothiazide (500 mg bolus i.v.). Patients were studied after one month of twice-daily administration of: placebo (P): chlorothiazide (...) 500 mg (C); furosemide 40 mg (F); furosemide with spironolactone (100 mg b.i.d.) for the last 36 hours (F + S; N = 6). During F therapy, furosemide-induced natriuresis was followed by six hour periods of decreased UNaV. Diuretic therapy with F or C for one month reduced BP, but did not alter body weight, plasma volume (PV), glomerular filtration rate or PAH clearance. After P, the test infusion of furosemide increased fractional Na excretion (FENa) by +10.5 +/- 0.7%; this increment was reduced

1989 Kidney international Controlled trial quality: uncertain

1615. Frusemide, ACE inhibition, renal dopamine and prostaglandins: acute interactions in normal man. Full Text available with Trip Pro

Frusemide, ACE inhibition, renal dopamine and prostaglandins: acute interactions in normal man. 1. The acute effects of intravenous frusemide (30 mg) on prostaglandin dependent renal haemodynamics, urinary prostaglandin excretion, urinary dopamine excretion and electrolyte excretion were studied in six salt replete healthy volunteers with and without pretreatment with the angiotensin converting enzyme (ACE) inhibitor, ramipril (5 mg) and compared with the effects of ramipril alone in order (...) kallikrein excretion. Pretreatment with ramipril did not affect these responses. 4. Frusemide increased the excretion of urinary PGE2 and 6-keto-PGF1 alpha. Ramipril pretreatment did not suppress this rise in prostaglandin excretion. Since the frusemide induced prostaglandin dependent renal haemodynamic changes were also not suppressed with ACE inhibition, this suggests that in salt-replete volunteers AII does not significantly modulate renal prostaglandin production after frusemide. 5. Urinary free

1989 British journal of clinical pharmacology Controlled trial quality: uncertain

1616. The influence of dopamine-1 receptor blockade on the humoral and renal effects of low-dose atrial natriuretic factor in human hypertensives. (Abstract)

, or ANF + D-sulpiride at the same doses, for 60 min. The sequence of the three treatments was random, with a 72-h interval between treatments. The ANF infusion, which increased plasma ANF within the physiological range, significantly increased urinary sodium excretion, fractional sodium excretion and haematocrit; it reduced plasma aldosterone and tended to reduce plasma renin activity without changing blood pressure, the heart rate, renal plasma flow or the glomerular filtration rate. D-Sulpiride (...) , when given alone, significantly increased mean blood pressure and reduced absolute and fractional sodium excretion without changing the heart rate, glomerular filtration rate, renal plasma flow, haematocrit, plasma renin activity or plasma aldosterone. When infused with D-sulpiride, ANF did not change absolute or fractional sodium excretion or haematocrit. This study provides evidence that dopaminergic mechanisms play a role in the natriuretic and plasma volume effects of a synthetic human ANF

1989 Journal of hypertension. Supplement : official journal of the International Society of Hypertension Controlled trial quality: uncertain

1617. Nicorandil, a new vasodilator drug, in patients with essential hypertension. (Abstract)

, though reduced, after 24 h; no change in the heart rate was observed. The results from the upright position were similar. There were no significant changes in urine volume and electrolyte excretion during the nicorandil administration. The three different doses of nicorandil caused similar acute blood pressure reductions without change in the heart rate, nor in the urine volume and urinary sodium. (...) nicorandil as a single acute dose every other day. Blood pressure and the heart rate were measured in both supine and upright positions at various times for 24 h after the dosing; fractional urine collections were obtained at the end of the placebo period and after each active dose. All doses of nicorandil similarly and significantly (P less than 0.01) reduced supine blood pressure, with a peak after 4-6 h (10 mg: -21/-8 mmHg; 20 mg: -20/-9 mmHg; 30 mg: -29/-17 mmHg), and the effect was still present

1989 Journal of hypertension. Supplement : official journal of the International Society of Hypertension Controlled trial quality: uncertain

1618. Safety and efficacy of ibuprofen versus indomethacin in preterm infants treated for patent ductus arteriosus: a randomised controlled trial. (Abstract)

treatment, side-effects and clinical course. The efficacy of the pharmacological treatment was similar in the two groups (56/81, 69% INDO; 69/94, 73% IBU). Patients treated with INDO showed a significant increase in serum creatinine (89 +/- 24 versus 82 +/- 20 mmol/l, P = 0.03) and a near-significant tendency for a lower fractional excretion of sodium (3 +/- 3 versus 4 +/- 2%, P = 0.08); moreover, 12/81 (15%) INDO patients versus 1/94 (1%) IBU patients became oliguric (< 1 ml/kg per h) during treatment

2002 European journal of pediatrics Controlled trial quality: uncertain

1619. The effects of fenoldopam on renal function in patients undergoing elective aortic surgery. (Abstract)

. Twenty-eight ASA II-III patients undergoing elective aortic surgery requiring infrarenal aortic cross-clamping were studied. According to random allocation, patients received either fenoldopam (0.1 microg kg(-1) min(-1)) or placebo intravenously prior to surgical skin incision until release of the aortic clamp. Plasma creatinine, creatinine clearance, urinary output, fractional excretion of sodium, and free water clearance were measured: (a) prior to admission to hospital; (b) during the period from

2002 European Journal of Anaesthesiology Controlled trial quality: uncertain

1620. Fenoldopam: renal and splanchnic effects in patients undergoing coronary artery bypass grafting. (Abstract)

gastrointestinal mucosal perfusion by selective splanchnic vasodilation. We examined the effects of fenoldopam on haemodynamic parameters, creatinine clearance, fractional excretion of sodium, urine output, free water clearance and gastric mucosal pH in 31 patients undergoing elective coronary revascularisation. Patients were randomly assigned to receive continuous infusions of fenoldopam 0.1 microg x kg(-1) x min(-1) (n = 16) or placebo (n = 15). Renal parameters were measured: during a 24-h period before

2001 Anaesthesia Controlled trial quality: uncertain

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