RESUMO
After measurement of normal renal function, dog kidneys (n = 52) were subjected to 3, 15, or 30 min of normothermic warm ischemia (WI). After 24 hr of preservation by simple hypothermic storage (SHS) in a modified Collins solution, autotransplant was done and renal function was again measured beginning at 1 hr. Compared with preharvest values, kidneys with minimal (3 min) WI had significantly decreased clearances of creatinine (Cr) and para-aminohippuric acid (PAH), PAH extraction, absolute and fractional Na reabsorption, Na excretion, and urinary Na concentration; no change in urine flow rate or K excretion; and significantly increased fractional excretion of Na, K, and H2O. Compared with minimal WI, 30-min WI produced further significant decreases in clearances of Cr, PAH, and PAH extraction; and further increases in fractional excretion of Na, K, and H2O. Urine flow was also decreased by about half and urine Na concentration rose significantly. Several parameters were very significantly correlated with the length of WI, but the most reliable index was the fractional reabsorption of Na. When several functional parameters were used together, kidneys with significant (30 min) WI prior to preservation could be identified with a high degree of statistical reliability.
Assuntos
Isquemia/fisiopatologia , Transplante de Rim , Animais , Temperatura Baixa , Cães , Feminino , Taxa de Filtração Glomerular , Rim/irrigação sanguínea , Rim/fisiologia , Masculino , Potássio/metabolismo , Sódio/metabolismo , Preservação de Tecido , Transplante Autólogo , Ácido p-Aminoipúrico/metabolismoRESUMO
Injury to the kidney from blunt trauma occurs rather frequently in the active, pediatric patient. Early evaluation and treatment of these children is essential in order to preserve maximum renal function. Ninety cases of pediatric renal trauma from blunt injury have been reviewed. The majority of these responded well to careful conservative, non-operative management. Many of those requiring surgical intervention responded well to initial conservative treatment followed by surgical intervention conducted as an elective procedure within the first week after injury. Five case reports with associated radiographic studies are presented.
Assuntos
Rim/lesões , Ferimentos não Penetrantes , Adolescente , Criança , Pré-Escolar , Feminino , Humanos , Rim/diagnóstico por imagem , Masculino , Radiografia , Ferimentos não Penetrantes/diagnóstico por imagem , Ferimentos não Penetrantes/cirurgia , Ferimentos não Penetrantes/terapiaRESUMO
Two methods are described to cool the kidney. The surgact type of device can cover the entire kidney or a single pole. The second method for cooling the kidney is use of an intracellular hypothermic solution with methylprednisolone; the kidney is flushed via the renal artery to achieve cooling. Two interesting cases are presented which illustrate the methods used to achieve hypothermia.
