ABSTRACT
This paper was designed to investigate the correlation between the renal clearance and the plasma concentration of creatinine. Of the curve obtained, three segments were studied: 1 - When the glomerular filtration rate (GFR) was greater than 60 ml per min. the plasma concentration fluctuated between 0.44 and 1.59 mg/dl. 2 - When GFR was between 30 and 60 ml per min. the plasma concentration reached 2.4 mg/dl, and 3 - When GFR was less than 30 ml per min. the plasma level increased to values as high as 28 ml/min. The urinary concentration of creatinine can be divided into two broad groups depending on the GFR. The boundary of this division is around 60 ml per min. This suggests that when GFR is depressed there would exist a limitation of the tubular secretion of creatinine or urinary dilution problems. It is demonstrated that there is a poor correlation between creatinine clearance and its plasma concentration, and hence the repeated measurement of creatinine clearance becomes imperative in the follow-up of patients.
Subject(s)
Creatinine/pharmacokinetics , Kidney/physiology , Adolescent , Adult , Aged , Creatinine/blood , Creatinine/urine , Female , Glomerular Filtration Rate , Humans , Male , Middle AgedSubject(s)
Epoprostenol/deficiency , Pre-Eclampsia/physiopathology , Angiotensin II/physiology , Blood Platelets/metabolism , Blood Vessels/metabolism , Disseminated Intravascular Coagulation/physiopathology , Female , Humans , Pregnancy , Pregnancy Complications, Hematologic/physiopathology , Thrombocytopenia/physiopathology , Thromboxane A2/physiologySubject(s)
Pre-Eclampsia/etiology , Autoimmune Diseases/complications , Disseminated Intravascular Coagulation/complications , Female , Hemodynamics , Humans , Ischemia/complications , Kidney Diseases/complications , Parity , Placenta/blood supply , Placenta/immunology , Pre-Eclampsia/immunology , Pre-Eclampsia/physiopathology , Pregnancy , Renin-Angiotensin System , Uterus/blood supplyABSTRACT
Se revisan los conceptos actuales sobre la etiologia y la fisiopatogenia de la preeclampsia, se relacionan entre si y se describe un modelo fisiopatogenico que resulta muy razonable. Es posible que un trastorno inmunologico de repercusion sistemica, promovido por la placenta en contra de si misma, sea el evento inicial en la genesis de la preeclampsia. Esta respuesta inmunologica del organismo materno ocasiona isquemia placentaria que a su vez determina disminucion de la sintesis de progesterona, la cual es antagonista de la aldosterona, por lo que se produce un desbalance en el sodio corporal que permite la retencion de agua y una mayor respuesta de la angiotensina y de la renina con la consiguiente hipertension arterial. La reaccion inmunologica tambien puede ser causante del dano renal y de la coagulacion intravascular diseminada la cual favorece la isquemia en diferentes organos.Estas alteraciones son capaces de retroalimentarse a si mismas hasta su perpetuacion o hasta la eliminacion del tejido placentario al interrumpirse el embarazo
