Acute Oliguric Renal Failure in Man: Evidence for Preferential Renal Cortical Ischemia

Pharmacokinetics of cefamandole in rabbits with experimentally induced renal impairment.

“…Studies carried out on rats show a progressive decrease in renal blood flow rate and whole kidney and single nephron glomerular filtration rates6). Renal hemodynamic alterations similar to those observed after uranil nitrate administration have been reported in human acute renal impairment of varied etiologies9, 10,14).…”

Methods for the assessment of the effects of drugs on renal blood flow.

“…Four components have been isolated from 35-40 min curves (Rosen, Hollenberg, Daly & Merrill 1968;Hollenberg et al, 1968) and three components were identified from the 20-30 min curves (Ladefoged, 1966) (Figure 2). However, it was shown (Dell, Siacca, Lieberman, Case & Cannon, 1973) that there were no significanct differences in the estimation of the flows in each compartment made from 20 min curves from those made from 40-60 min curves.…”

John P. Merrill

“…We used the 133 xenon method that entailed the direct injection into the renal artery of the gamma emitter xenon 133 with simultaneous selective renal arteriography. We were the first to demonstrate that the underlying renal hemodynamic abnormality in both acute renal failure and the acute renal dysfunction of the transplanted kidney comprised renal hypoperfusion with a selective renal cortical ischemia (37). We also demonstrated that the acute oliguric renal failure of liver disease (now termed the hepatorenal syndrome) was characterized by intense renal cortical ischemia that was more profound than that observed in classic acute renal failure (38).…”

“…At a preclinical level, gifted research fellows including Thomas Biber, Gilbert Thiel, Franklin McDonald, Gerald DiBona, and Walter Flamenbaum conducted elegant studies in diverse rat models that contributed importantly to the elucidation of its pathogenesis. Concomitantly, Norman Hollenberg and I conducted a series of clinical studies to delineate the intrarenal hemodynamic alterations that underlie the clinical abnormalities of diverse acute renal failure syndromes (37,38). We used the 133 xenon method that entailed the direct injection into the renal artery of the gamma emitter xenon 133 with simultaneous selective renal arteriography.…”