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      Renal Tubular Sodium and Water Excretion in Antibiotic-Induced Nephrotoxicity

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          Abstract

          Clearance techniques were used to evaluate renal tubular sodium and water excretion in 4 patients with antibiotic-induced acute renal failure (ARF). Creatinine clearances and maximal urine flow rates of patients with ARF (22.6 and 5.23 ml/min, respectively) were significantly lower than control values during hypotonic volume expansion (125.5 and 13.71 ml/min, respectively, both p < 0.01). During the period of maximal hydration, fractional sodium excretion (CNa/Ccr) and maximal urine osmolality (11.4% and 171 mosm/kg H<sub>2</sub>O, respectively) were increased compared to controls (1.04% and 53 mosm/kg H<sub>2</sub>O, respectively, both p < 0.05). The increased C<sub>Na</sub>/C<sub>cr</sub> observed in patients with ARF was consistent with reduced proximal sodium reabsorption as reflected by increased (C<sub>H2 O</sub> + C<sub>Na</sub>)/C<sub>Cr</sub> and reduced fractional distal sodium reabsorption as indicated by decreased C<sub>H2 O</sub>/(C<sub>H2 O</sub> + C<sub>Na</sub>). The reduction in proximal and distal sodium reabsorption cannot be explained on the basis of an osmotic effect of urea as fractional clearances of BUN (C<sub>bun</sub>/c<sub>cr</sub>) were similar in patients with ARF and controls.

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          Author and article information

          Journal
          NEF
          Nephron
          10.1159/issn.1660-8151
          Nephron
          S. Karger AG
          1660-8151
          2235-3186
          1978
          1978
          02 December 2008
          : 20
          : 4
          : 227-234
          Affiliations
          Nephrology Division, Department of Internal Medicine, The University of Michigan, Ann Arbor, Mich.
          Article
          181226 Nephron 1978;20:227–234
          10.1159/000181226
          634420
          8a5106e1-d30b-458e-9f90-489e630851ea
          © 1978 S. Karger AG, Basel

          Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

          History
          : 14 December 1976
          : 10 June 1977
          Page count
          Pages: 8
          Categories
          Original Paper

          Cardiovascular Medicine,Nephrology
          Antibiotic nephroxicity,Free water clearance,Fractional sodium reabsorption

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