The clinician and estimation of glomerular filtration rate by creatinine-based formulas: current limitations and quo vadis.

The GFR has a paramount diagnostic and staging role in the Kidney Disease Outcome Quality Initiative Clinical Practice Guidelines for Chronic Kidney Disease (K/DOQI-CKD). The most widely used serum creatinine-based formulas in adults for estimated GFR (eGFR) are the Cockcroft-Gault (CG) and Modification of Diet in Renal Disease Study (MDRD). Recently, a new Chronic Kidney Disease Epidemiology Collaboration equation has been developed.

Exercise and dehydration: A possible role of inner ear in balance control disorder.

To study the effect of exercise and dehydration on the postural sensory-motor strategies, 10 sportsmen performed a 45 min-exercise on a cycle ergometer at intensity just below the ventilatory threshold without fluid intake. They performed, before, immediately and 20 min after exercise, a sensory organization test to evaluate balance control in six different sensory situations, that combine three visual conditions (eyes open, eyes closed and sway-referenced visual surround motion) with two platform conditions (stable platform, sway-referenced platform motion). Blood samples were collected before and after exercise.

Estimating glomerular filtration rate: Cockcroft-Gault and Modification of Diet in Renal Disease formulas compared to renal inulin clearance.

Background And Objectives: Evaluation of renal function by estimation of the glomerular filtration rate (GFR) is very important for the diagnosis and treatment of patients with chronic kidney disease (CKD). The Cockcroft-Gault (CG) and Modification of Diet in Renal Disease (MDRD) formulas are the most commonly used estimations.

Design, Setting, Participants, & Measurements: Estimated GFR values by each formula were compared with measured GFR (mGFR) by renal inulin clearance in 2208 European adults (46% women, 1.

Reporting the eGFR and its implication for CKD diagnosis.

The process of diagnosing chronic kidney disease using the estimated GFR involves several pitfalls. The estimated GFR laboratory report should be requested only by practitioners who are familiar with how to interpret the result. Until a more reliable method is available to estimate the GFR, the current chronic kidney disease classification should be revised by reducing the central role of the GFR cutoff levels.

Myocardial lactate deprivation is associated with decreased cardiovascular performance, decreased myocardial energetics, and early death in endotoxic shock.

Objective: We examined whether lactate availability is a limiting factor for heart function during endotoxic shock, and whether lactate deprivation thus induces heart energy depletion, thereby altering cardiovascular performance. The study goals were to determine whether muscle lactate production is linked to beta(2)-stimulation and to ascertain the effects of systemic lactate deprivation on hemodynamics, lactate metabolism, heart energetics, and outcome in a lethal model of rat's endotoxic shock.

Interventions: We modulated the adrenergic pathway in skeletal muscle using microdialysis with ICI-118551, a selective beta(2)-blocker.

Comparative effects of vasopressin, norepinephrine, and L-canavanine, a selective inhibitor of inducible nitric oxide synthase, in endotoxic shock.

Norepinephrine (NE), a standard of care, AVP, an alternative candidate, and L-canavanine (LC), a selective inhibitor of inducible nitric oxide synthase, were compared for efficacy and innocuousness on global and regional hemodynamics, plasmatic and tissue lactate-to-pyruvate ratio (L/P), tissue high-energy phosphates, renal function, and tissue capillary permeability in a rat model of endotoxic normokinetic shock. Mean arterial pressure (MAP) decreased ( approximately 35%) but aortic blood flow increased during endotoxin infusion (P < 0.05 vs.

Predicting GFR in children and adults: a comparison of the Cockcroft-Gault, Schwartz, and modification of diet in renal disease formulas.

Background: A rapid prediction of glomerular filtration rate (GFR) is often needed in clinics. Formulas based on plasma creatinine level are being increasingly used, Schwartz for children, supposed to give GFR; Cockcroft-Gault for adults, supposed to indicate the creatinine clearance; and a recent formula introduced by the Modification of Diet in Renal Disease (MDRD) group. Our objective was to test whether one single formula could suffice and which one gives the best estimation of GFR.

Comparative effects of dexamethasone and L-canavanine in experimental septic shock.

Glucocorticoids can reverse hemodynamic disturbances and dependence on catecholamines in septic shock. The relevant beneficial mechanisms of steroids in septic shock are unknown, although inducible nitric oxide synthase could account for them. The aim of this study was to compare the effects of dexamethasone, a glucocorticoid and L-canavanine, a selective inhibitor of inducible nitric oxide synthase, in a rodent model of sepsis.

Effects of epinephrine and norepinephrine on hemodynamics, oxidative metabolism, and organ energetics in endotoxemic rats.

Objective: To determine whether epinephrine increases lactate concentration in sepsis through hypoxia or through a particular thermogenic or metabolic pathway.

Design: Prospective, controlled experimental study in rats.

Setting: Experimental laboratory in a university teaching hospital.

Effects of exercise-induced fatigue with and without hydration on static postural control in adult human subjects.

Postural instability can be the result of various factors, including fatigue. Although it is well known that exercise-induced fatigue may be responsible for a decrease in performance, its effects on postural control, as well as those of hydration, have been relatively little explored. This study evaluated the effects of fatigue, with and without rehydration, on postural control in 10 healthy subjects who regularly practice sports activities.

Constitutive nitric oxide synthase inhibition combined with histamine and serotonin receptor blockade improves the initial ovalbumin-induced arterial hypotension but decreases the survival time in brown norway rats anaphylactic shock.

Anaphylactic shock accidents after allergen exposure are frequent. After immunization with ovalbumin (OVA), a common dietary constituent, we evaluated the efficacy of pretreatment with histamine-receptor or serotonin-receptor blockers administered alone or in combination with a nitric oxide synthase inhibitor (L-NAME) on OVA-induced anaphylactic shock in Brown Norway rats. Animals were allocated to the following groups (n = 6 each): control (0.

Hemodynamic effects of early versus late glucocorticosteroid administration in experimental septic shock.

Recent findings in human septic shock suggest that glucocorticosteroids can limit and even reverse hemodynamic disturbances and dependence on catecholamines. In a rodent model of hypotensive and hypokinetic septic shock, we investigated the effects of early or late dexamethasone administration on hemodynamics, response to catecholamines, and cardiac beta-adrenergic signalling. As compared with sham-operated rats, the untreated septic rats displayed significant arterial hypotension and reduced aortic blood flow.