The Experts below are selected from a list of 162 Experts worldwide ranked by ideXlab platform
Dae Hyuk Moon - One of the best experts on this subject based on the ideXlab platform.
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Value of the Filtration Fraction Assessed by Dynamic 99m Tc-Diethylenetriaminepentaacetic Acid Renal Scintigraphy After Angiotensin-Converting Enzyme Inhibition for the Diagnosis of Renovascular Hypertension
Nuclear medicine and molecular imaging, 2019Co-Authors: Eonwoo Shin, Changhwan Sung, Hye Joo Son, Dong Yun Lee, Sun Young Chae, Dae Hyuk MoonAbstract:Purpose This study aimed to determine the diagnostic value of the relative Filtration Fraction (RFF) assessed by dynamic 99mTc-diethylenetriaminepentaacetic acid (99mTc-DTPA) renal scintigraphy after angiotensin-converting enzyme (ACE) inhibition for renovascular hypertension (RVHT) diagnosis. Methods 99mTc-DTPA captopril renal scintigraphy performed in adolescents or adults (≥ 10 years) with suspected RVHT was retrospectively reviewed. The RFF of the affected kidney was qualitatively assessed as the relative glomerular Filtration rate during the 2 to 3-min period compared with the relative perfusion during the first 60 s (qualitative RFF) and scored from 1 (definitely same) to 5 (definitely decreased). The quantitative RFF of the affected kidney was obtained by dividing the percentage of glomerular Filtration rate by the percentage of renal perfusion. Results Overall, 173 patients (high probability, n = 15; and low probability, n = 158) were included based on conventional captopril renal scintigraphic criteria. An abnormal qualitative RFF was observed in 12 patients with high probability, and the diagnostic sensitivity was 80.0% (95% CI, 51.9-95.7). The RFF was normal in 152 patients with low probability, and the diagnostic specificity was 96.2% (95% CI, 91.9-98.6). The RFF was lower in patients with high probability than in those with low probability (0.79 ± 0.15 vs. 1.02 ± 0.11, P
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value of the Filtration Fraction assessed by dynamic 99m tc diethylenetriaminepentaacetic acid renal scintigraphy after angiotensin converting enzyme inhibition for the diagnosis of renovascular hypertension
Nuclear Medicine and Molecular Imaging, 2019Co-Authors: Eonwoo Shin, Changhwan Sung, Hye Joo Son, Dong Yun Lee, Sun Young Chae, Dae Hyuk MoonAbstract:Purpose This study aimed to determine the diagnostic value of the relative Filtration Fraction (RFF) assessed by dynamic 99mTc-diethylenetriaminepentaacetic acid (99mTc-DTPA) renal scintigraphy after angiotensin-converting enzyme (ACE) inhibition for renovascular hypertension (RVHT) diagnosis. Methods 99mTc-DTPA captopril renal scintigraphy performed in adolescents or adults (≥ 10 years) with suspected RVHT was retrospectively reviewed. The RFF of the affected kidney was qualitatively assessed as the relative glomerular Filtration rate during the 2 to 3-min period compared with the relative perfusion during the first 60 s (qualitative RFF) and scored from 1 (definitely same) to 5 (definitely decreased). The quantitative RFF of the affected kidney was obtained by dividing the percentage of glomerular Filtration rate by the percentage of renal perfusion. Results Overall, 173 patients (high probability, n = 15; and low probability, n = 158) were included based on conventional captopril renal scintigraphic criteria. An abnormal qualitative RFF was observed in 12 patients with high probability, and the diagnostic sensitivity was 80.0% (95% CI, 51.9-95.7). The RFF was normal in 152 patients with low probability, and the diagnostic specificity was 96.2% (95% CI, 91.9-98.6). The RFF was lower in patients with high probability than in those with low probability (0.79 ± 0.15 vs. 1.02 ± 0.11, P < 0.0001). Conclusions The RFF assessed by dynamic 99mTc-DTPA renal scintigraphy after ACE inhibition can detect patients with high probability for RVHT. The RFF after ACE inhibition might be a useful diagnostic criterion especially when baseline scintigraphy is not available for evaluating ACE inhibition-induced changes.
Christopher G Winearls - One of the best experts on this subject based on the ideXlab platform.
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circuit life versus bleeding risk the impact of achieved activated partial thromboplastin time versus achieved Filtration Fraction
Therapeutic Apheresis and Dialysis, 2015Co-Authors: Clare Macewen, Peter J Watkinson, Christopher G WinearlsAbstract:Whilst prolonging hemofilter (circuit) life, heparin increases bleeding risk. The impact of achieved activated partial thromboplastin time (APTT) on circuit life and bleeding risk has not been assessed in a modern critically ill cohort. Lowering Filtration Fraction may be an alternative means of prolonging circuit life, but is often overlooked in critical care. An observational study of 309 consecutive circuits in a general intensive care unit was conducted using a wide target APTT range. Multilevel modeling was used to predict circuit life and bleeding according to achieved APTT and Filtration Fraction. Independent predictors of circuit failure (i.e. unplanned ending of treatment) included Filtration Fraction (P < 0.001, HR 1.07 per 1% increase), peak APTT (P < 0.001, HR 0.8 per 10 s increase or 0.3 APTR increase) and baseline PT (P = 0.014, HR 0.91 for every 50% increase). The only significant predictor of bleeding was peak APTT (P = 0.017, OR 1.05 per 10 s increase). Every 10 s APTT increase was associated with a 20% reduction in circuit failure, but a 5% increase in hemorrhage. A 3% reduction in Filtration Fraction was associated with the same improvement in circuit life as a 10 s increase in APTT. Increasing APTT prolongs circuit life but carries a substantial risk of bleeding even in modern practice. Filtration Fraction has a large impact on circuit life in the critically ill: a 3% reduction in Filtration Fraction, e.g. by increasing blood flow or delivering some of the clearance via dialysis, would be expected to reduce circuit failure as much as a 10 s increase in APTT.
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Circuit Life Versus Bleeding Risk: The Impact of Achieved Activated Partial Thromboplastin Time Versus Achieved Filtration Fraction
Therapeutic apheresis and dialysis : official peer-reviewed journal of the International Society for Apheresis the Japanese Society for Apheresis the , 2014Co-Authors: Clare Macewen, Peter J Watkinson, Christopher G WinearlsAbstract:Whilst prolonging hemofilter (circuit) life, heparin increases bleeding risk. The impact of achieved activated partial thromboplastin time (APTT) on circuit life and bleeding risk has not been assessed in a modern critically ill cohort. Lowering Filtration Fraction may be an alternative means of prolonging circuit life, but is often overlooked in critical care. An observational study of 309 consecutive circuits in a general intensive care unit was conducted using a wide target APTT range. Multilevel modeling was used to predict circuit life and bleeding according to achieved APTT and Filtration Fraction. Independent predictors of circuit failure (i.e. unplanned ending of treatment) included Filtration Fraction (P
R. B. Cross - One of the best experts on this subject based on the ideXlab platform.
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acute lowering of plasma oncotic pressure increases Filtration Fraction and sodium excretion in conscious sheep
Kidney & Blood Pressure Research, 1992Co-Authors: S J Fleming, C R Dallemagne, Zoltan H Endre, N E Yesberg, R. B. CrossAbstract:We examined the effect of acutely lowering the colloid osmotic pressure by removing plasma (36.2 ± 3.1 ml/kg) and replacing it with Hartmann’s solution (93.0 ± 8.2 ml/kg) in 6 conscious merino sheep.
Laville M - One of the best experts on this subject based on the ideXlab platform.
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Effects of Rilmenidine on stress-induced peak blood pressure and renal function
Journal of cardiovascular pharmacology, 1999Co-Authors: Jean Pierre Fauvel, Najem R, Ryon B, Ducher M, Laville MAbstract:Rilmenidine is an imidazoline I1-receptor agonist that centrally acts by reducing the sympathetic tone. There is strong experimental evidence that natriuresis could be evoked by proximal tubular I1-receptors that have also been isolated in human kidneys. However, in humans, the natriuretic effects of proximal tubular I1-receptors have never been demonstrated. Because stress tests elicited a sympathetically mediated increase in blood pressure and in sodium reabsorption, this study examined whether a short-term infusion of rilmenidine (1 mg) may interfere with stress-induced cardiovascular response and renal sodium handling in normotensive men, in a double-blind, crossover, placebo-controlled study. The stress test used is an efficient and reproducible computerized version of the Stroop's stress test. During the experimental sessions, both basal and stress renal functional parameters were determined: glomerular Filtration rate, renal plasma flow, Filtration Fraction, sodium excretion, and segmental sodium tubular reabsorption (lithium clearance). During the placebo phase, stress induced a significant increase in systolic blood pressure (SBP; 22.2+/-10.1 mm Hg) and diastolic blood pressure (DBP; 11.0+/-5.0 mm Hg). During stress, glomerular Filtration rate and renal plasma flow tended to decrease, resulting in a nonsignificant increase in Filtration Fraction. Despite the increase in BP, stress induced a significant decrease in sodium excretion that was due mainly to a nonsignificant increase in sodium reabsorption in the proximal parts of the tubules. Rilmenidine significantly reduced rest and stress BP, but the cardiovascular reactivity to stress was not altered. The treatment slightly decreased basal glomerular Filtration rate and increased renal plasma flow, so that the Filtration Fraction significantly decreased. The treatment-related decrease in BP was associated with a significant increase in basal sodium reabsorption. Stress-induced modifications in renal function and sodium handling were not altered by the treatment. In conclusion, rilmenidine reduced rest BP and preserved stress-induced reactivity in BP and heart rate. Renal effects of rilmenidine are characterized by a decrease in glomerular Filtration rate and in Filtration Fraction and an increase in sodium reabsorption. The study failed to demonstrate any effect of rilmenidine on stress-induced increase in sodium reabsorption.
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Fonction rénale au cours du stress chez l'hypertendu.
Archives des maladies du coeur et des vaisseaux, 1991Co-Authors: S. Daoud, A. Hadj-aissa, Laville M, Madeleine Vincent, M. Labeeuw, Nicole Pozet, P. ZechAbstract:In this study, the measurement of blood pressure values, glomerular Filtration rate (GFR, inulin clearance), renal plasma flow (RPF, PAH clearance), the Filtration Fraction (GFR/RPF), natiuresis and proximal sodium resorption (measured by lithium clearance), was performed at rest and during a computerised psychological stress test (Stroop word color conflict test) in 12 normotensive and 10 hypertensive subjects. The stress induced in the normotensives induced a significant increase of the Filtration Fraction and proximal tubule sodium resorption. The hypertensive kidney, submitted to a basal vasoconstriction greater than that of the normotensive kidney, does not react to stress. In the hypertensives, proximal sodium resorption occurs but is not significantly greater than at rest. In the long-term, the increased sodium resorption during stress could contribute to the development and the persistence of essential hypertension.
Eonwoo Shin - One of the best experts on this subject based on the ideXlab platform.
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Value of the Filtration Fraction Assessed by Dynamic 99m Tc-Diethylenetriaminepentaacetic Acid Renal Scintigraphy After Angiotensin-Converting Enzyme Inhibition for the Diagnosis of Renovascular Hypertension
Nuclear medicine and molecular imaging, 2019Co-Authors: Eonwoo Shin, Changhwan Sung, Hye Joo Son, Dong Yun Lee, Sun Young Chae, Dae Hyuk MoonAbstract:Purpose This study aimed to determine the diagnostic value of the relative Filtration Fraction (RFF) assessed by dynamic 99mTc-diethylenetriaminepentaacetic acid (99mTc-DTPA) renal scintigraphy after angiotensin-converting enzyme (ACE) inhibition for renovascular hypertension (RVHT) diagnosis. Methods 99mTc-DTPA captopril renal scintigraphy performed in adolescents or adults (≥ 10 years) with suspected RVHT was retrospectively reviewed. The RFF of the affected kidney was qualitatively assessed as the relative glomerular Filtration rate during the 2 to 3-min period compared with the relative perfusion during the first 60 s (qualitative RFF) and scored from 1 (definitely same) to 5 (definitely decreased). The quantitative RFF of the affected kidney was obtained by dividing the percentage of glomerular Filtration rate by the percentage of renal perfusion. Results Overall, 173 patients (high probability, n = 15; and low probability, n = 158) were included based on conventional captopril renal scintigraphic criteria. An abnormal qualitative RFF was observed in 12 patients with high probability, and the diagnostic sensitivity was 80.0% (95% CI, 51.9-95.7). The RFF was normal in 152 patients with low probability, and the diagnostic specificity was 96.2% (95% CI, 91.9-98.6). The RFF was lower in patients with high probability than in those with low probability (0.79 ± 0.15 vs. 1.02 ± 0.11, P
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value of the Filtration Fraction assessed by dynamic 99m tc diethylenetriaminepentaacetic acid renal scintigraphy after angiotensin converting enzyme inhibition for the diagnosis of renovascular hypertension
Nuclear Medicine and Molecular Imaging, 2019Co-Authors: Eonwoo Shin, Changhwan Sung, Hye Joo Son, Dong Yun Lee, Sun Young Chae, Dae Hyuk MoonAbstract:Purpose This study aimed to determine the diagnostic value of the relative Filtration Fraction (RFF) assessed by dynamic 99mTc-diethylenetriaminepentaacetic acid (99mTc-DTPA) renal scintigraphy after angiotensin-converting enzyme (ACE) inhibition for renovascular hypertension (RVHT) diagnosis. Methods 99mTc-DTPA captopril renal scintigraphy performed in adolescents or adults (≥ 10 years) with suspected RVHT was retrospectively reviewed. The RFF of the affected kidney was qualitatively assessed as the relative glomerular Filtration rate during the 2 to 3-min period compared with the relative perfusion during the first 60 s (qualitative RFF) and scored from 1 (definitely same) to 5 (definitely decreased). The quantitative RFF of the affected kidney was obtained by dividing the percentage of glomerular Filtration rate by the percentage of renal perfusion. Results Overall, 173 patients (high probability, n = 15; and low probability, n = 158) were included based on conventional captopril renal scintigraphic criteria. An abnormal qualitative RFF was observed in 12 patients with high probability, and the diagnostic sensitivity was 80.0% (95% CI, 51.9-95.7). The RFF was normal in 152 patients with low probability, and the diagnostic specificity was 96.2% (95% CI, 91.9-98.6). The RFF was lower in patients with high probability than in those with low probability (0.79 ± 0.15 vs. 1.02 ± 0.11, P < 0.0001). Conclusions The RFF assessed by dynamic 99mTc-DTPA renal scintigraphy after ACE inhibition can detect patients with high probability for RVHT. The RFF after ACE inhibition might be a useful diagnostic criterion especially when baseline scintigraphy is not available for evaluating ACE inhibition-induced changes.