The Effect of Hemoglobin on Renal Function in the Human

Miller, John H.; McDonald, Roger K.

doi:10.1172/jci102522

Cited by 84 publications

(35 citation statements)

References 19 publications

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“…The observation that a delay period of four to 25 minutes elapsed between the end of the rapid injection of hemoglobin and the appearance of hemoglobinuria is consistent with an ischemia of some glomeruli with subsequent increased permeability when blood flow is reestablished. The fact that the glomerular permeability to hemoglobin was significantly higher when the individuals received a single rapid injection than when they received a slow infusion supports this speculation; for only with the rapid administration of hemoglobin was there an intense, initial renal vasoconstriction (7). The association of proteinuria with decreased glomerular filtration rate and renal blood flow has been observed by others (16,17).…”

Section: Resultssupporting

confidence: 53%

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Human Glomerular Permeability and Tubular Recovery Values for Hemoglobin

McDonald¹,

Miller²,

Roach³

1951

J. Clin. Invest.

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Section: Resultssupporting

confidence: 53%

“…Subject selection criteria, the general test procedure, laboratory analyses and the preparation and administration of hemoglobin have been described previously (7).…”

Section: Methodsmentioning

confidence: 99%

Human Glomerular Permeability and Tubular Recovery Values for Hemoglobin

McDonald¹,

Miller²,

Roach³

1951

J. Clin. Invest.

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“…Many recent publications incriminate some alteration in the renal circulatory bed as a primary factor in the production and/or maintenance of most states of acute renal insufficiency (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13). On the one hand, measurements of renal blood flow made by use of the Fick principle either at the onset of the injury or subsequent to an ensuing anuric or oliguric period have shown a significant renal ischemia associated with surgical and hemorrhagic shock, abortion, incompatible blood transfusions, heavy metal poisoning, hemoglobin infusions, and carbon tetrachloride poisoning (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11).…”

mentioning

confidence: 99%

“…On the one hand, measurements of renal blood flow made by use of the Fick principle either at the onset of the injury or subsequent to an ensuing anuric or oliguric period have shown a significant renal ischemia associated with surgical and hemorrhagic shock, abortion, incompatible blood transfusions, heavy metal poisoning, hemoglobin infusions, and carbon tetrachloride poisoning (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11). The accuracy of some of these measurements is open to question because of the almost negligible renal extraction of the test substance involved and the difficulties of urine collection during severe oliguria.…”

mentioning

confidence: 99%

A Study of the Renal Circulation, Tubular Function and Morphology, and Urinary Volume and Composition in Dogs Following Mercury Poisoning and Transfusion of Human Blood 1

Conn¹,

Wilds²,

Helwig³

et al. 1954

J. Clin. Invest.

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Many recent publications incriminate some alteration in the renal circulatory bed as a primary factor in the production and/or maintenance of most states of acute renal insufficiency (1-13). On the one hand, measurements of renal blood flow made by use of the Fick principle either at the onset of the injury or subsequent to an ensuing anuric or oliguric period have shown a significant renal ischemia associated with surgical and hemorrhagic shock, abortion, incompatible blood transfusions, heavy metal poisoning, hemoglobin infusions, and carbon tetrachloride poisoning (1-11). The accuracy of some of these measurements is open to question because of the almost negligible renal extraction of the test substance involved and the difficulties of urine collection during severe oliguria. However, this body of data has been interpreted as indicating that an initial renal ischemia is primarily responsible for the development of renal insufficiency and ultimately anuria produced by all insults not directly nephrotoxic; and that renal ischemia probably is present throughout the period of anuria whatever the initial cause. On the other hand, Trueta Raspall (12), using the results of rabbit experiments, has proposed that the important vascular abnormality is an intrarenal "juxtamedullary shunting" of blood presumably with a normal over-all flow. The continuation of this "shunting" throughout the period of renal inadequacy is implied.Since the "shunt" hypothesis has been widely challenged and the other not yet entirely documented, consideration of these concepts raises cer1This work was supported in part by the National Heart Institute of the U. S. Public Health Service (H 405) and: in part by a University of Pennsylvania Faculty Research Grant.2Research Fellow of the American Heart Association during the tenure of this study. tain related questions: 1) Do intrarenal shunts in the intact subject ever play any part in the development or continuation of renal insufficiency states? 2) Does an initial renal ischemia persist to become a major contributor to the continuation of renal insufficiency or to the commonly associated anuria? With the development of a gas diffusion method for measuring renal blood flow which does not require urine for analysis (14) and with the application of newer arteriographic techniques, more direct and more satisfactory answers can now be given to these questions.In the absence of readily available clinical material, two abnortnal conditions which might simulate those leading to acute anuria in humans were created in dogs: bichloride of mercury poisoning and an incompatible blood transfusion reaction. Then at the time of anticipated maximal urinary suppression, the renal circulatory behavior and tubular function were studied by correlating measurements of renal blood flow, intrarenal distribution of flow, renal para-amino-hippurate (PAH) extraction, and renal arteriovenous oxygen differences with urinary and post mortem renal morphological changes. METHODSThe two methods of producing renal or urinary t...

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“…The early studies showed considerable side effects, most notably renal impairment due to vasoconstriction [75][76][77]. As a consequence, SHF has been abandoned as blood substitute.…”

Section: Stroma-free Haemoglobin (Sfh)mentioning

confidence: 99%