Neonatal edema.

Edema develops in the neonate from diverse clinical conditions; sometimes it heralds serious underlying disorders. In this review, we discuss the diagnosis and treatment of edema in the neonate.

Edema in childhood.

There are two types of edema: localized edema and generalized edema. The causes of generalized edema in childhood are diverse. Formation of generalized edema involves retention of sodium and water in the kidney. The treatment of generalized edema depends on the primary etiology. Supportive nutritional and medical therapies are needed to prevent further edema. These and related features of edema in childhood are discussed in this review.

Plants as a source of salt.

Ecological and ethnobotanical aspects of some halophylous plants are presented. These plants possess several morphophysiological adaptations to face salinity in their habitats. They are a source of salt and could represent new potential crops in saline environments.

A contribution to the history of common salt.

Salt has influenced human nutrition, health, politics, taxation, economy, freight, transport, and commerce throughout the ages. All human activities have been influenced by salt including economy, religious beliefs and practices, art, literature, psychoanalysis, superstitions, and exorcism. Salt is recognized as a symbol for friendship, hospitality, chastity, alliance, table fellowship, fidelity, fertility, blessing, curse and endurance, etc. The Bible is the first book of salt and contains no fewer than 24 references to this substance. In the Gospels the parable of salt is a central one. Many many church fathers have written on salt a substance, which up to 1969 was a relevant element in the rite of Baptism. This paper reviews the importance of common salt for human life, and by drawing from various scientific and literary sources makes a special discussion of its various symbolisms.

Creatinine clearance: an inadequate marker of renal filtration in patients with early posthepatitic cirrhosis (Child A) without fluid retention and muscle wasting.

Glomerular filtration rate (GFR) was measured in 19 patients with Child A liver cirrhosis by comparing the endogenous creatinine clearance with inulin clearance. Inulin clearance averaged 90 +/- 4.4 ml/min x 1.73 m2, while creatinine clearance averaged 122 +/- 7 ml/min x 1.73 m2 (p < 0.001). The overestimation of GFR by creatinine was present in 18 of 19 patients and was inversely correlated with inulin clearance (r = -0.452, p < 0.04). The data point to the unsuitability of creatinine as a marker of filtration in early posthepatitic cirrhosis (Child A).

Renal synthesis of prostaglandins and thromboxane has no causative role for protein-induced glomerular hyperfiltration in healthy humans.

The study was devised to establish the role of prostaglandin E2, prostaglandin1 alpha and thromboxane A2 in the genesis of glomerular hyperfiltration response to a meat meal in healthy humans. To this end, a group of 8 healthy women was studied 4 times: in the control state (study 1), after a meat meal (study 2), following a meat meal associated with intravenous aspirin (study 3) and finally after a meat meal associated with intravenous aspirin following 2-day pretreatment with oral aspirin (study 4). Urinary excretion of prostaglandins and thromboxane increased during the glomerular hyperfiltration response to a meat meal and was suppressed by aspirin administration which did not suppress the renal hemodynamic response to the meat meal. The data do not support a causal role for prostaglandins and thromboxane A2 in the hemodynamic response to acute protein loading.

Renal handling of sodium after an oral protein load in adult humans.

This investigation was designed to study (1) renal sodium handling after an oral protein load and (2) its relationship to some known determinants of the hemodynamic response (glucagon, insulin, growth hormone, renin, aldosterone, and plasma amino acid concentration). To this end of group of 8 adult subjects was studied before (three 30-min clearances) and after a meat meal (MM; five 30-min clearances at 30, 60, 90, 120 and 180 min). The MM provided 2 g/kg BW of protein. Within 30 min from the MM an hyperfiltration response was seen, which was paralleled by a 2-fold increase in plasma alanine concentration while total plasma amino acid concentration was not different from the baseline values. The hemodynamic response was associated with a normally operating tubuloglomerular feedback mechanism independent of renin-aldosterone activity, but possibly associated with an early increase in plasma glucagon concentration and later on with a modest increase in postmeal plasma insuling concentration.

Predicted creatinine clearance to assess glomerular filtration rate in chronic renal disease in humans.

The work was designed to assess the suitability of both measured endogenous creatinine clearance (CCR) and predicted creatinine clearance (P-CCR) to evaluate GFR in chronic renal disease (CRD) by utilizing the renal clearance of inulin (CIN) as gold standard. A total of 124 subjects were studied (62 healthy, 62 with CRF). CCR significantly overestimated GFR in healthy subjects as well as in CRF, whereas P-CCR was identical to GFR. The CCR/CIN ratio which calculates the fractional creatinine clearance and provides a rough estimation of the contribution of creatinine secretion in explaining the differences between CCR and GFR was increased in CRD and especially in CRD of glomerular origin. The ration P-CCR/CIN was significantly lower than CCR/CIN in healthy subjects and in patients with CRD of glomerular origin. The data are against the use of CCR in assessing GFR in healthy subjects and in patients with CRD.

Age-related changes in renal reserve and renal tubular function in healthy humans.

To explore the age-related changes in tubular function and in the renal reserve (RR) a total of 98 healthy subjects were studied while on free living conditions. Enrolled people were divided into 3 groups: group A (n = 40, age range 5-18 years, Na intake 80 +/- 20 mM/day, protein intake 1.30 +/- 0.76 g/kg BW); group B (n = 34, age range 19-60 years, Na intake 110 +/- 12 mM/day, protein intake 1.32 +/- 0.75 g/kg BW), and group C (n = 24, age range 61-89 years, Na intake 159 +/- 12 mM/day (p less than 0.01 vs. A and B), protein intake 1.26 +/- 0.23). Glomerular filtration rate (GFR) (inulin), renal plasma flow (p-aminohippurate), the amount of filtrate and sodium delivered from the proximal tubule (lithium clearance), endogenous creatinine clearance, and predicted creatinine clearance were measured. The RR was evaluated after a meat meal (providing 2 g/kg BW of proteins) by subtracting baseline GFR from the peaking postprandial GFR. GFR was age-related and was identical in groups A and B and significantly lower in group C (p less than 0.0001). The drop in GFR averaged 7% per decade in the age range 61-89 years. The RR was not statistically different in groups A and B and increased significantly in group C (p less than 0.0001). In groups A and B the filtration fraction was constant after the meat meal and significantly increased over baseline GFR in group C (p less than 0.01), while the percentage of filtration capacity utilized at rest was lower in group C (p less than 0.0001).(ABSTRACT TRUNCATED AT 250 WORDS)

Lithium clearance in patients with chronic renal failure.

Lithium clearance (CLi) was studied in the healthy subjects (H) and in patients with chronic renal failure (CRF) with a mean GFR of 36.08 +/- 3.8 ml/min x 1.73 m2 in order to evaluate (1) the variability of CLi measurements; (2) the changes of CLi during the hyperfiltration response to a meat meal (2 g/kg b.w. of protein), and (3) the effects on CLi of different protein intakes. CLi correlated with GFR and with urinary sodium, FeLi correlated with FeNa in H and CRF. The intraindividual standard deviation (IISD) of GRF, CLi and FeLi assessed in triplicate studies in the course of a single experiment averaged 4.70, 7.15 and 10.69% in CRF and 1.77, 4.09 and 4.61% in H. When IISD for GFR, CLi, and FeLi was assessed in triplicate measurements in the course of 3 studies performed at 1-week intervals (day 1, day 8, day 15), it averaged 7.36, 9.21 and 15.72% in CRF and 1.83, 5.08 and 5% in H. During the hyperfiltration response to a meat meal, CLi and FeLi did not change in CRF and increased significantly in H. In 10 patients with CRF who were switched for 3 weeks from a protein intake of 0.85 g/kg to a protein intake of 0.60 g/kg, GFR was significantly (p less than 0.001) reduced by 29%, while CLi was stable. The data indicate that because of its variability, CLi is of little use in experiments designed to study subtle changes in renal Na transport.

Circadian rhythm with acrophase at night for urinary excretion of calcium and magnesium in childhood: population-based data of the cimitile study in southern Italy.

A population-based study on daily and overnight urine excretion of Ca and Mg was performed in 220 children aged 4-15 years living in Cimitile, Campania Region, Southern Italy. The Ca/creatinine and the Mg/creatinine ratio in overnight urine were significantly higher than in daily urine (p less than 0.01). This finding was also confirmed in hypercalciuric children. The Mg/Ca ratio in the general population was identical in daily and overnight urine while in the hypercalciuric group Mg/Ca in overnight urine was significantly higher (p less than 0.01) than in daily urine. The data point to the existence of a circadian rhythm with a peak at night for urine Ca and Mg excretion in children living in Cimitile and studied while attending to their everyday life.