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Effect of Mannitol, Saline, and Urea on the Function of a Recently Autotransplanted Kidney

Effect of Mannitol, Saline, and Urea on the Function of a Recently Autotransplanted Kidney Abstract MINIMIZING ischemic damage to a donor kidney to insure prompt function is an important factor in successful renal homotransplantation. The purpose of this experiment was to test if mannitol would be useful for this purpose and to compare its effectiveness and possible mechanism of action with that of saline and urea. Methods Twenty-three dogs were anesthetized with pentobarbital (Nembutal) and placed on a respirator with room air. Carotid-artery pressure was continuously recorded. Test solutions were injected into an external jugular catheter. The left kidney was excised and connected to the right iliac vessels. Bilateral catheters were inserted.Twenty percent mannitol, 20% urea, 6.7% urea, and normal saline were injected over three to four minutes using the following doses: 20% mannitol at 500 mg/kg (2.5 cc/kg); 20% urea at 500 mg/kg (2.5 cc/kg); 6.7% urea at 167 mg/kg (2.5 cc/kg); normal saline at 2.5 cc/kg.Solutions of 6.7% and 20% urea References 1. Smith, L.; Berman, L.; and Chisholm, G.: Effect of Mannitol on Renal Function During Cardiovascular Surgery , Surg Forum 14:103, 1963. 2. Callaway, J.; Pinkerton, J.; and Foster, J.: Prevention of Acute Renal Failure , Surg Forum 14:101, 1963. 3. Doberneck, R.; Schwartz, F.; and Barry, K.: Comparison of Prophylactic Value of 20% Mannitol, 4% Urea, 5% Dextrose on the Effects of Renal Ischemia , J Urol 89:300, 1963. 4. Beall, A., et al: Mannitol Diuresis in Vascular Surgery , Arch Surg 86:34, 1963.Crossref 5. Barry, K.G., and Malloy, J.P.: Oliguric Renal Failure , JAMA 179:510, 1962.Crossref 6. Nosowsky, E., and Kaufman, J.: Protective Action of Mannitol in Renal Artery Occlusion , J Urol 89:295, 1963. 7. Parry, W.; Schaefer, A.; and Mueller, B.: Experimental Studies of Acute Renal Failure , J Urol 89:1, 1963. 8. Lempert, N.; Baba, A.; and Powers, S.: Correction of Oliguric Response to Trauma With 10% Mannitol , Surg Forum 12:90, 1961. 9. Peters, G., and Brunner, H.: Mannitol Diuresis in Hemorrhagic Hypotension , Amer J Physiol 204( (2) ):555, 1963. 10. Dempster, W.J.: Reassessment of Anuria After Kidney Transplantation , Brit Med J 1( (2) ):1697, 1963.Crossref 11. Starzl, T.: Experience in Renal Transplantation , Philadelphia: W. B. Saunders Co., 1964. 12. Humphries, A., et al: Successful Reimplantation of the Canine Kidney After 24-Hour Storage , Surgery 54:136, 1963. 13. Telander, R.: Prolonged Normothermic Perfusion of Isolated Baboon and Sheep Kidney , Surg Forum 13:378, 1962. 14. Anderson, M.: Function of Totally Denervated Rabbit Kidney , Scand J Clin Lab Invest 14:343, 1962.Crossref 15. Leary, F.J.; Utz, D.; and Wakim, K.: Effect of Continuous and Intermittent Renal Ischemia on Renal Function , Surg Gynec Obstet 116:311, 1963. 16. Hardin, C., and Valk, W.L.: Effects of Temporary Ischemia on Renal Function Under Normal and Hypothermic Temperatures With Aortic Renal Graft Replacement , Surg Gynec Obstet 106:82, 1958. 17. Bricker, N.S., et al: The Functional Capacity of the Kidney Denervated by Autoransplantation in the Dog , J Clin Invest 37:185, 1958.Crossref 18. Doberneck, R.; Schwartz, F.; and Barry, K.: On the Nature of the Nonspecific Nephropathy Attributed to Mannitol , Proc Soc Exp Biol Med 110:795, 1962.Crossref 19. Murphy, G.; Gagnon, J.; and Teschan, P.: Renal Hemodynamic Effect of Mannitol in Normotension and Hypotension , Surg Forum 14:99, 1963. 20. Wright, H., and Gann, D.: Effect of Mannitol on Renal Hemodynamics During Extracellular Fluid Volume Depletion and Expansion , Surg Forum 14:97, 1963. 21. Goeller, V., and Schlegel, J.: Observations on Renal Flood Flow and Its Dependence on Fluid Administration , Surg Forum 12:487, 1961. 22. Winton, F.R.: " Hydrostatic Pressure Affecting the Flow of Urine and Blood in Kidney ," Harvey Lectures 1951-52 . Academic Press 47, 1953. 23. Murphy, G.; Gagnon, J.; and Teschan, P.: Measurement of Renal Function in Hemorrhagic Hypotension-Effect of Mannitol , J Urol 90( (2) ):133, 1963. 24. Selkurt, E.: Changes in Renal Clearance Following Complete Ischemia of the Kidney , Amer J Physiol 144:395, 1945. 25. Selkurt, E.: Renal Blood Flow in Clearance of Hemorrhagic Shock , Amer J Physiol 145:696, 1946. 26. Lassen, N.; Munck, O.; and Thaysen, J.H.: Renal Oxygen Consumption , Acta Physiol Scand 51:371, 1961.Crossref 27. Martin, D.: Partial Pressure of Oxygen in Urine and Its Significance , Surg Forum 14:496. 1963. 28. Leonhardt, K., and Landes, R.: Oxygen Tension of Urine and Renal Structures , New Eng J Med 269( (3) ):115, 1963.Crossref 29. Hostnik, W., et al: Hemodynamics and Oxygen Tension in Urine and Renal Vein , Surg Forum 10:872, 1959. 30. Aukland, K.: Urine Oxygen Tension , Acta Physiol Scand 55:362, 1962.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Surgery American Medical Association

Effect of Mannitol, Saline, and Urea on the Function of a Recently Autotransplanted Kidney

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Publisher
American Medical Association
Copyright
Copyright © 1966 American Medical Association. All Rights Reserved.
ISSN
0004-0010
eISSN
1538-3644
DOI
10.1001/archsurg.1966.01320200018003
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Abstract

Abstract MINIMIZING ischemic damage to a donor kidney to insure prompt function is an important factor in successful renal homotransplantation. The purpose of this experiment was to test if mannitol would be useful for this purpose and to compare its effectiveness and possible mechanism of action with that of saline and urea. Methods Twenty-three dogs were anesthetized with pentobarbital (Nembutal) and placed on a respirator with room air. Carotid-artery pressure was continuously recorded. Test solutions were injected into an external jugular catheter. The left kidney was excised and connected to the right iliac vessels. Bilateral catheters were inserted.Twenty percent mannitol, 20% urea, 6.7% urea, and normal saline were injected over three to four minutes using the following doses: 20% mannitol at 500 mg/kg (2.5 cc/kg); 20% urea at 500 mg/kg (2.5 cc/kg); 6.7% urea at 167 mg/kg (2.5 cc/kg); normal saline at 2.5 cc/kg.Solutions of 6.7% and 20% urea References 1. Smith, L.; Berman, L.; and Chisholm, G.: Effect of Mannitol on Renal Function During Cardiovascular Surgery , Surg Forum 14:103, 1963. 2. Callaway, J.; Pinkerton, J.; and Foster, J.: Prevention of Acute Renal Failure , Surg Forum 14:101, 1963. 3. Doberneck, R.; Schwartz, F.; and Barry, K.: Comparison of Prophylactic Value of 20% Mannitol, 4% Urea, 5% Dextrose on the Effects of Renal Ischemia , J Urol 89:300, 1963. 4. Beall, A., et al: Mannitol Diuresis in Vascular Surgery , Arch Surg 86:34, 1963.Crossref 5. Barry, K.G., and Malloy, J.P.: Oliguric Renal Failure , JAMA 179:510, 1962.Crossref 6. Nosowsky, E., and Kaufman, J.: Protective Action of Mannitol in Renal Artery Occlusion , J Urol 89:295, 1963. 7. Parry, W.; Schaefer, A.; and Mueller, B.: Experimental Studies of Acute Renal Failure , J Urol 89:1, 1963. 8. Lempert, N.; Baba, A.; and Powers, S.: Correction of Oliguric Response to Trauma With 10% Mannitol , Surg Forum 12:90, 1961. 9. Peters, G., and Brunner, H.: Mannitol Diuresis in Hemorrhagic Hypotension , Amer J Physiol 204( (2) ):555, 1963. 10. Dempster, W.J.: Reassessment of Anuria After Kidney Transplantation , Brit Med J 1( (2) ):1697, 1963.Crossref 11. Starzl, T.: Experience in Renal Transplantation , Philadelphia: W. B. Saunders Co., 1964. 12. Humphries, A., et al: Successful Reimplantation of the Canine Kidney After 24-Hour Storage , Surgery 54:136, 1963. 13. Telander, R.: Prolonged Normothermic Perfusion of Isolated Baboon and Sheep Kidney , Surg Forum 13:378, 1962. 14. Anderson, M.: Function of Totally Denervated Rabbit Kidney , Scand J Clin Lab Invest 14:343, 1962.Crossref 15. Leary, F.J.; Utz, D.; and Wakim, K.: Effect of Continuous and Intermittent Renal Ischemia on Renal Function , Surg Gynec Obstet 116:311, 1963. 16. Hardin, C., and Valk, W.L.: Effects of Temporary Ischemia on Renal Function Under Normal and Hypothermic Temperatures With Aortic Renal Graft Replacement , Surg Gynec Obstet 106:82, 1958. 17. Bricker, N.S., et al: The Functional Capacity of the Kidney Denervated by Autoransplantation in the Dog , J Clin Invest 37:185, 1958.Crossref 18. Doberneck, R.; Schwartz, F.; and Barry, K.: On the Nature of the Nonspecific Nephropathy Attributed to Mannitol , Proc Soc Exp Biol Med 110:795, 1962.Crossref 19. Murphy, G.; Gagnon, J.; and Teschan, P.: Renal Hemodynamic Effect of Mannitol in Normotension and Hypotension , Surg Forum 14:99, 1963. 20. Wright, H., and Gann, D.: Effect of Mannitol on Renal Hemodynamics During Extracellular Fluid Volume Depletion and Expansion , Surg Forum 14:97, 1963. 21. Goeller, V., and Schlegel, J.: Observations on Renal Flood Flow and Its Dependence on Fluid Administration , Surg Forum 12:487, 1961. 22. Winton, F.R.: " Hydrostatic Pressure Affecting the Flow of Urine and Blood in Kidney ," Harvey Lectures 1951-52 . Academic Press 47, 1953. 23. Murphy, G.; Gagnon, J.; and Teschan, P.: Measurement of Renal Function in Hemorrhagic Hypotension-Effect of Mannitol , J Urol 90( (2) ):133, 1963. 24. Selkurt, E.: Changes in Renal Clearance Following Complete Ischemia of the Kidney , Amer J Physiol 144:395, 1945. 25. Selkurt, E.: Renal Blood Flow in Clearance of Hemorrhagic Shock , Amer J Physiol 145:696, 1946. 26. Lassen, N.; Munck, O.; and Thaysen, J.H.: Renal Oxygen Consumption , Acta Physiol Scand 51:371, 1961.Crossref 27. Martin, D.: Partial Pressure of Oxygen in Urine and Its Significance , Surg Forum 14:496. 1963. 28. Leonhardt, K., and Landes, R.: Oxygen Tension of Urine and Renal Structures , New Eng J Med 269( (3) ):115, 1963.Crossref 29. Hostnik, W., et al: Hemodynamics and Oxygen Tension in Urine and Renal Vein , Surg Forum 10:872, 1959. 30. Aukland, K.: Urine Oxygen Tension , Acta Physiol Scand 55:362, 1962.Crossref

Journal

Archives of SurgeryAmerican Medical Association

Published: Feb 1, 1966

References