Renal Hemodynamic Effects of Hypertonic Mannitol Infusions.

Braun, William E.; Lilienfield, Lawrence S.

doi:10.3181/00379727-114-28570

Cited by 48 publications

(18 citation statements)

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“…However, a careful examination of previous studies in both humans and laboratory animals reveals that glomerular filtration rate fell in some studies, often when bolus injections were made or urine volume replacement was potentially inadequate (1,3). One explanation may be that large losses of urine volume resulted without adequate replacement and volume depletion could have produced this decrement in clearance.…”

Section: Discussionmentioning

confidence: 99%

“…The widespread use of mannitol in clinical medicine in an effort to increase, maintain, or restore glomerular filtration rate has inspired a large number of studies which have examined the mechanism of action of this useful agent (1)(2)(3)(4)(5)(6)(11)(12)(13)(14). Most investigators have favored an increase in either or both rpf and PG as the major factors contributing to this beneficial effect.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, sngfr does increase with mannitol and this increase is not wholly dependent upon an increase in nephron plasma flow since the major factor increasing EFP was decreased 7rA INTRODUCTION There is evidence from both the reijal physiology laboratory (1)(2)(3)(4) and the clinical experience (5,6) This work was presented in part at The 6th Annual Meeting of The American Society of Nephrology, Washington, D. C., November 1973 and published as an abstract in the 1973 Abstracts of the American Society of Nephrology; 6:…”

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confidence: 99%

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Effect of Mannitol on Glomerular Ultrafiltration in the Hydropenic Rat

Blantz¹

1974

J. Clin. Invest.

116

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A B S T R A C T The effect of mannitol upon glomerular ultrafiltration was examined in hydropenic MunichWistar rats. Superficial nephron filtration rate (sngfr) rose from 32.0±:0.9 nl/min/g kidney wt to 42.0±1.6 (P < 0.001) in eight rats. Hydrostatic pressure gradients acting across the glomerular capillary (AP) were measured in glomerular capillaries and Bowman's space with a servo-nulling device, systemic (IrA) and efferent arteriolar oncotic pressures (7rE) were determined by microprotein analysis. These data were applied to a computer-based mathematical model of glomerular ultrafiltration to determine the profile of effective filtration pressure (EFP = AP -7r) and total glomerular permeability (LpA) in both states. Filtration equilibrium obtained in hydropenia (LpA ) 0.099± 0.006 nl/s/g kidney wt/mm Hg) and sngfr rose because EFP increased from a maximum value of 4.2±t1.1 to 12.8±0.5mm Hgaftermannitol (P <0.01). This increase was due to both increased nephron plasma flow and decreased 7rA. Computer analysis of these data revealed that more than half (> 58%) of this increase was due to decreased WA, consequent to dilution of protein. Since EFP was disequilibrated after mannitol, LpA could be calculated accurately (0.065 ± 0.003 nl/s/g kidney wt/mm Hg) and was significantly lower than the minimum estimate in hydropenia.Therefore, sngfr does increase with mannitol and this increase is not wholly dependent upon an increase in nephron plasma flow since the major factor increasing EFP was decreased 7rA INTRODUCTION There is evidence from both the reijal physiology laboratory (1-4) and the clinical experience (5,6)

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Effect of Mannitol on Glomerular Ultrafiltration in the Hydropenic Rat

Blantz¹

1974

J. Clin. Invest.

116

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“…Our data demonstrate conclusively that this suggestion is correct. A number of investigators have found that mannitol (20)(21)(22)(23) and other hypertonic solutions (24) can increase renal blood flow and decrease renal vascular resistance in the normal dog kidney. It seems plausible that renal vascular resistance is increased in the hypoperfused rat kidney, perhaps at the afferent arterioles.…”

Section: Introductionmentioning

confidence: 99%

Restoration and maintenance of glomerular filtration by mannitol during hypoperfusion of the kidney

Morris¹,

Alexander²,

Bruns³

et al. 1972

J. Clin. Invest.

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A B S T R A C T Glomerular filtration (GF) during progressive reduction of renal perfusion pressure by aortic clamping was studied in hydropenic rats and in rats infused with isotonic saline, hypertonic saline, or mannitol. As judged by visual observation of Lissamine green movements in superficial nephrons, GF was absent in hydropenic or saline-loaded rats at 40 mm Hg aortic pressure, but continued in some nephrons of all rats infused with mannitol and of some rats infused with hypertonic saline. Urine flow persisted only in rats infused with mannitol. By use of the qualitative Hanssen technique, it was found that all glomeruli in superficial and deep portions of the cortex were perfused at 40 mm Hg in all groups of rats. By the same method, GF continued in 1% of nephrons in hydropenic rats, 12% of nephrons in isotonic saline-loaded rats, and 78% of nephrons in rats infused with mannitol. By means of a quantitative Hanssen technique, GF was 5.8 nl/min per nephron in mannitol-infused rats and not measurable (<0.5 nl) in hydropenic rats. Superficial and deep nephrons were similar in both qualitative and quantitative studies. Although urine flow did not persist in rats infused with hypertonic saline, GF was detected in four of seven studies by the Hanssen method (mean, 9.1 nl/min per nephron). In additional experiments, mannitol infused after perfusion pressure had already been-lowered to 40 mm Hg in hydropenic rats reestablished urine flow and GF (mean, 9.8 nl/min). Furosemide, isotonic and hypertonic saline did not restart urine flow; however, GF (Lissamine green) was restarted by hypertonic saline. We conclude that mannitol can maintain or reestablish by an extratubular mechanism GF which otherwise would not occur during renal hypoperfusion. Hypertonic saline has a similar effect on GF in some cases, but urine

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“…The increase in renal blood flow observed in dog kidneys was not associated with significant change in glomer ular filtration rate [25]. Mannitol, like al bumin, has been reported to have vasodilatory effects in the intact as well as isolated perfused kidneys of dogs and rats [3,5,11,18,27,31,33].…”

Section: Introductionmentioning

confidence: 99%

Effects of Albumin and Mannitol on Blood Flow Autoregulation in Isolated Dog Kidneys

Kleinman¹,

Buffington²,

Luber³

et al. 1979

Kidney Blood Press Res

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In isolated blood-perfused dog kidneys, additions of bovine serum albumin abolished blood flow autoregulation. Replacing the perfusate with fresh blood or adding mannitol restored autoregulation. When mannitol alone was added, autoregulation also decreased, but less than with albumin alone, and subsequent addition of albumin abolished autoregulation. Diminished distal water and electrolyte delivery, subcapsular renal pressure, and vascular reactivity to angiotensin II occurred with albumin addition. Mannitol ameliorates the effect of albumin on autoregulation by increasing intrarenal tissue pressure and distal delivery.

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Renal Hemodynamic Effects of Hypertonic Mannitol Infusions.

Cited by 48 publications

References 0 publications

Effect of Mannitol on Glomerular Ultrafiltration in the Hydropenic Rat

Effect of Mannitol on Glomerular Ultrafiltration in the Hydropenic Rat

Restoration and maintenance of glomerular filtration by mannitol during hypoperfusion of the kidney

Effects of Albumin and Mannitol on Blood Flow Autoregulation in Isolated Dog Kidneys

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