Measurements of glomerular filtration rate (GFR), effective renal plasma flow (ERPF), tubular maximum reabsorption of glucose (Tmglucose) and secretion of para-aminohippurate (Tmpah), clearance of inorganic phosphate (Cphosphate) and uric acid (Curic acid), urine diluting capacity (CH2O) and urinary net acid excretion (UH + V) were made before and 10 to 14 days after unilateral nephrectomy in seven healthy renal donors. Comparisons were made between the functions of the remaining kidney and 50% of pre-uninephrectomy values. Mean post-uninephrectomy GFR increased by 36%, and mean ERPF, 55%. Tmglucose, Tmpah, Cphosphate, uric acid, CH2O, UH + V increased significantly, after uninephrectomy. The increase in Tmpah, Tmglucose and CH2O is proportional to the rise in GFR while the increase in Cphosphate, Curic acid and UH + V is proportionally greater than the increase in GFR. The changes in post-uninephrectomy renal handling of phosphate are not due to an increase in parathyroid hormone secretion.

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Thirty renal transplant recipients received 0.5 ml of Influenza Virus Vaccine, Bivalent, USP, intramuscularly. Serum hemagglutination-inhibiting and nasal secretory neutralizing antibodies were measured before and 3 to 4 weeks after vaccination. Creatinine clearance and urinary protein excretion were measured before and weekly for 4 to 8 weeks after vaccination. Ten of 13 patients (77%) with creatinine clearance of greater than or equal to 70 ml/min-1.73m2 (group I) had greater than or equal to a fourfold increase in hemagglutination-inhibiting antibody titers to influenza A or B virus after vaccination, while only six of 17 patients (35%) with creatinine clearance of greater than 70 ml/min-1.73m2 (group II) had a similar increase (chi-square = 5.129; P less than 0.05). Six of 13 patients (46%) in group I had greater than or equal to a fourfold increase in neutralizing antibody titers to influenza A or B virus after vaccination, whereas none in group II had a similar increase (chi-square = 7.135; P less than 0.01). There were no adverse effects on the allografts. Only minor side effects were noted in a few patients. Because of its safety and antigenicity, influenza vaccination should be offered to renal transplant recipients particularly during threats of epidemic outbreaks.

The use of potent diuretics in acute renal failure remains controversial. Both beneficial and detrimental effects have been reported. In the present study, the effects of both low and high doses of furosemide administered in the developmental and established stages of mercuric chloride-induced acute renal failure were evaluated. Both low and high doses of furosemide produced a significant diuresis when given early in the course of experimental acute renal failure. Despite this diuresis, furosemide did not modify the development of the acute renal failure. Continued administration of a low dose of furosemide had no effect on renal function; however, prolonged administration of high doses of furosemide resulted in significantly lower creatinine clearances 48 hr after induction of acute renal failure. This detrimental effect was due to sodium depletion by the diuretic since it was prevented by continuous replacement of urinary sodium losses. In the absence of sodium depletion, high doses of furosemide produced a significant diuresis, both in the developmental and established phases of acute renal failure, but it had no effect on the degree of renal functional impairment.