Renal Blood Flow in Anuric Human Subject Determined by Use of Radioactive Krypton 85

Abstract

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Studies on the Mechanism of Oliguria in a Model of Unilateral Acute Renal Failure

“…Four mechanisms have been implicated: (a) renal vasoconstriction, (b) development of an aglomerular shunt pathway, (c) tubular obstruction, and (d) back leakage of filtrate. Although observations have been made which could be compatible with the latter three possibilities (1)(2)(3)(4)(5)(6), the majority of recent data support alterations in renal resistance as the major determinant of diminished filtration in acute renal failure (7)(8)(9)(10)(11)(12). Data obtained from micropuncture and hemodynamic studies have led to the view that marked afferent arteriolar constriction decreases effective filtration pressure and glomerular filtration rate.…”

Studies of the Acute Renal Effects of Hemolyzed Red Blood Cells in Dogs Including Estimations of Renal Blood Flow With Krypton85*

“…Bull, Joekes, and Lowe (24) and Sirota (25), using the direct Fick-PAH technique, concluded that RPF was extremely low during the late oliguric and early diuretic phases of acute tubular necrosis. However, Conn, Wilds, and Helwig (7), Brun and colleagues (15), Munck (16), and Meriel, Galinier, and Suc (26), employing the gas diffusion method to study RBF, demonstrated in both dogs and humans with severe oliguria that RBF was not negligible, but 30 to 50 per cent normal in most studies. These flows are compatible with considerable glomerular filtration.…”

“…These flows are compatible with considerable glomerular filtration. Two patients during oliguria had normal blood flow values (15,26). Using krypton85, we have observed a normal RBF in a patient with oliguric acute renal failure after a hemolytic transfusion reaction (27).…”

“…This work was presented in part before the meeting of the Eastern Section of the American Federation for Clinical Research in Philadelphia, Pa., January 11, 1962. modifications of previous techniques. 1) RBFKr was estimated by an indirect Fick gas diffusion method (13,14) using krypton85 (15,16) and not involving the collection of urine, thereby providing a measure of renal hemodynamics independent of the clearance and direct Fick-PAH techniques previously used. Also, in contrast to direct methods of measuring RBF, surgical manipulation of the renal pedicle is not involved.…”

Glycerol-induced hemoglobinuric acute renal failure in the rat. I. Micropuncture study of the development of oliguria.

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The oliguria of acute renal failure has been attributed to tubular obstruction (1-12), "leakage" of the glomerular filtrate through rents in the tubular wall (13)(14)(15)(16)(17)(18)(19), and vascular mechanisms of various types (20)(21)(22)(23)(24)(25). In a previous paper, it was shown that the oliguria of mercury-induced acute renal failure in the rat reflects a primary decrease in glomerular filtration rate and cannot be attributed to tubular mechanisms (26).

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