Phenolsulfonphthalein Research Articles

Quantitative assessment of luminal stirring in the perfused small intestine of the rat.

We measured the resistance (RL) to CO absorption that resulted from poor luminal stirring in the constantly perfused rat jejunum. RL or calculated unstirred layer thickness was greater for 30-cm than 10-cm long segments, indicating lack of a uniform thickness of unstirred layer. The possibility that laminar flow existed in the gut was first tested by calculating expected CO absorptions from fluid moving with laminar flow. These values agreed closely with observed absorption rates. Laminar flow also was supported by the observation that CO absorption was independent of perfusate viscosity. Lastly, after sudden addition of phenolsulfonphthalein (PSP) to the perfusate, PSP outflow concentration was similar in tygon tubing (which has laminar flow) and a gut segment of comparable dimension. We conclude that flow in the perfused gut is laminar and that this laminar flow has many implications for studies carried out with the constant-perfusion technique.

Effects of nephrotoxic compounds on active uptake of drugs in isolated renal tubules in rabbits

The uptake of sulfonamides and phenolsulfonphthalein (PSP) was examined in vitro using isolated renal proximal tubule suspension, and the effects of nephrotoxic compounds on the uptake of sulfamethizole (SMZ) were studied. The uptake of SMZ and PSP was energy dependent and was inhibited competitively by iodopyracet (IP), which is transported actively by the p-aminohippurate mechanism. The uptake of sulfamethoxazole was also reduced by IP but that of sulfanilamide was negligible. The present results correspond well with those of in vitro experiments reported previously. Nephrotoxic compounds, mercuric chloride, neomycin, viomycin and kanamycin, decreased the uptake of SMZ non-competitively. The inhibitory action of the three antibiotics corresponds with in vivo potency, suggesting that this renal tubule preparation may provide a simple method for predicting the nephrotoxicity of drugs.

Relationship between postoperative blood pressure change and renal pathophysiology in primary aldosteronism.

32 patients with primary aldosteronism due to adrenal adenoma were studied to elucidate the relationship between blood pressure (BP) and renal functions before and after the removal of aldosteronoma. The relationship between either BP or renal functions and the structural changes of the renal biopsy specimens obtained at the operation was also examined. Renal function studies included serum urea nitrogen (BUN), creatinine, creatinine clearance (Ccr), phenolsulfonphthalein (PSP) test, and urine concentration test (max SG). Renal plasma flow (RPF), renal blood flow, and filtration fraction (FF) were measured. Serum sodium was significantly decreased and potassium was increased after the removal of the aldosteronomas. The levels of BUN, Ccr, PSP, and max SG were not significantly correlated to either pre- or postoperative BP levels, and to the improvement of hypertension after the operation. On the other hand, BP was significantly correlated with RPF and FF before surgery. Furthermore, the postoperative improvement of hypertension was correlated with the decrease of FF and the increase of hematocrit after surgery. The influence of duration of preoperative hypertension on BP response after adrenalectomy was not significant in the present study. The higher the BP level, the more marked histological changes were found. But, there was no relationship between renal functions and histological changes of renal biopsy specimens. The results indicate that RPF may participate in the hypertension of primary aldosteronism and that the BP level after surgery may be predicted by examination of the pathological changes present in the kidney.

P-259 - Studies on experimental renal damage in rats. III. Usefulness of serum half-life of phenolsulfonphthalein (PSP) as renal function test

P-259 - Studies on experimental renal damage in rats. III. Usefulness of serum half-life of phenolsulfonphthalein (PSP) as renal function test

Glomerular and proximal renal tubular function in pregnancy-associated hypertension: a prospective study

1. (1) 82 initially normotensive women with no past history of renal disease were studied at monthly intervals throughout pregnancy from 17 to 20 wk amenorrhea. 15 patients developed hypertension (blood pressure ( BP) 135 85 mm Hg lying on the left side) in the third trimester of pregnancy, and returned to normal values post partum. Glomerular filtration rate (GFR) as measured by true endogenous creatinine clearance was elevated throughout pregnancy in both groups, while proximal renal tubular function as measured by 15-min phenolsulfonphthalein (PSP) excretion, normal in early pregnancy, was abnormally low at 33–36 wk amenorrhea in those patients who developed hypertension, prior to the rise in BP in at least 60%. PSP excretion was also found to be low in continuously normotensive women with a history of hypertension in a previous pregnancy. Uric acid clearance was elevated in all patients in early pregnancy, but showed a tendency to fall as early as 29–32 wk amenorrhea ( P < 0.01) in those destined for hypertension, with a reciprocal rise in serum levels. 2. (2) It is clear that proximal renal tubular functional abnormalities appear before the onset of pregnancy-associated hypertension (P-AH), even in a mildly affected group such as the present one, and may well be involved in the initiating pathophysiological processes of the clinical syndrome.

Serum digoxin concentrations in healthy dogs treated without a loading dose

Healthy dogs were treated once‐a‐day for 20 days, with a liquid oral dosage form of digoxin (0.022 mg/kg). Serum digoxin concentrations, measured by radio immunoassay technique, were in the therapeutic range 8 h after the second daily dose of digoxin had been administered. Of the ten dogs treated, four had digoxin serum concentrations above those accepted to be moderately toxic. Results of a blood urea nitrogen and a phenolsulfonphthalein test, determined at days 0, 5, 8, 12, 15 and 19 after the beginning of the investigation all were within normal limits. Serum osmolality, calcium, potassium, and sodium, determined daily, evidenced no significant difference from control values. Lengthening of the PR interval and a decrease in the heart rate were observed. Digitalization of dogs can be achieved without the use of a loading dose and within a much shorter time than was previously reported.

Late follow-up in women with nephrosclerosis diagnosed at pregnancy

Thirteen nephroscelerotic women were followed for 2 to 7 years from the time a diagnosis was made following a pregnancy complicated by hypertension. Ten patients developed sustained hypertension. Twelve women who were examined responded with a hypertensive pattern to acute salt load. Of the 10 patients who were examined, seven had a reduced renal plasma flow (RPF) demonstrated by the phenolsulfonphthalein (PSP) excretion test. The present observations support the view that the vascular lesion in the kidneys precedes and persists independently of pregnancy. The pregnant state brings the hypertensive disease to clinical expression.

Intermittent Catheterization and Vesical Defenses

The effectiveness of intermittent catheterization in eradicating bacteriuria in patients requiring catheterization for inadequate voiding was subjected to a mathematical analysis to establish its theoretical basis. It can be shown that, at 1 extreme, with 6ml. urine remaining in the bladder, assuming reasonable hydration, catheterization must be done at least every 2 to 2½ hours to limit bacteriuria. In contrast, if as little as 0.5ml. urine is left behind, catheterization may be done every 4 to 5 hours to achieve the same result. Moreover, from the graphic depiction of the calculation it is seen that a reduction in the intervals between catheterization has a much greater effect than an increase in the urinary output in the reduction of the bacterial count.The volume of residual urine after catheterization was directly determined by measurement of Phenolsulfonphthalein that was washed out after drainage by catheter in the female dog and in women. In the dog it averaged 0.435ml. but in women it was somewhat greater than that after normal voiding.Upon applying the equation relating frequency of catheterization and urinary output to residual urine in a clinical program of intermittent catheterization, we found that the usual (convenient) schedule often resulted in showing that an unattainably small volume of urine would have to be left in the bladder. Actual measurement of residual urine by the modified phenolsulfonphthalein test provides the data needed to design a program of intermittent catheterization for each patient that will lead to urinary sterility

Nephrotoxicity of paraquat in mice

The nephrotoxicity of paraquat was evaluated by estimating renal function in vitro and in vivo in surviving mice 24 hr after an LD50 (7 day) dose of the herbicide. Proximal tubular function was monitored in vitro by measuring accumulation of p-aminohippurate (PAH) and N-methylnicotinamide (NMN) into renal cortical slices. Disappearance of phenolsulfonphthalein (PSP) and [ 14C]-paraquat from plasma was used to monitor tubular function in intact animals. Glomerular function was approximated using disappearance of iothalamate from plasma. Renal cortical accumulation of PAH and NMN in vitro was not markedly altered following paraquat poisoning. In contrast, dramatic effects were measured in vivo. The rate of disappearance of both [ 14C]-paraquat and PSP from plasma was significantly reduced in poisoned mice. In contrast, the rate of disappearance of iothalamate was not affected by paraquat. However, the concentration of iothalamate was higher in the plasma of treated animals, suggesting that paraquat poisoning results in a smaller volume of distribution for iothalamate but fails to alter glomerular filtration. Thus, the functional nephrotoxicity due to paraquat appears to be restricted to the proximal nephron. Elimination of paraquat is primarily via the kidney and likely involves active secretion into the urine. Since secretion requires concentration within the cells of the proximal tubules, it follows that toxic concentrations of herbicide might be reached in this area of the nephron. Furthermore, it follows that, should toxic concentrations of paraquat be reached in the kidney, subsequent impairment of renal function would impede elimination of the drug, leading to more profound toxicity in organs other than the kidney.

Effect of halogenated hydrocarbons on organic ion accumulation by renal cortical slices of rats and mice

The nephrotoxicity of CCl 4, CHCl 3 and 1,1,2-trichloroethane (TCE) was studied in male rats and mice by administering corn oil solutions of the agents at various times before the animals were sacrified and their kidneys removed. Thin renal cortical slices were incubated for 75 min in a pH 7.4 phosphate-Ringer buffer containing 36 m m k + and low concentrations of p-aminohippuric acid (PAH), phenolsulfonphthalein (PSP) or 14C-tetraethylammonium (TEA). Tissue accumulation of the organic ions was quantified by calculating the ratio of the concentrations of the ions in the slices and the medium. All 3 halogenated hydrocarbons inhibited the accumulation of PAH and PSP by rat kidney slices, although none of the 3 was as effective in this regard as HgCl 2. CCl 4 was the most consistently nephrotoxic of the halogenated hydrocarbons when given to the rat at sublethal doses (0.2–4.0 ml/kg). The maximum nephrotoxic effect occurred approximately 2 days after CCl 4 administration. CHCl 3 and TCE were less active in the rat in terms of maximum effect but were more potent than CCl 4. None of the 3 solvents affected the accumulation of TEA by rat kidney slices. In mice all 3 compounds inhibited PAH accumulation by the kidney slices. CHCl 3 was the most effective in terms of both maximum effect and potency. Inhibition of PAH transport was seen at doses as low as 0.005 ml/kg TCE was more potent than CCl 4 in the mouse although both produced about equal impairment of renal function. The maximum effect occurred 1 day after administration of the solvents to the mice.

Palmitate uptake and oxidation by kidney cortex slices: Effects of probenecid, p-aminohippurate and phenolsulfonphthalein

To test the suggestion made earlier that the p-aminohippurate (PAH) transport system might play a role in the transport of free fatty acids (FFA) in the kidney, a study has been made of the effects of probenecid, p-aminohippurate and phenolsulfonphthalein (PSP) on the net uptake and oxidation of palmitate by guinea pig kidney cortex slices. In Krebs-Ringer phosphate buffer with 2% albumin, 3–6 mM probenecid inhibited the oxygen consumption of the slices without affecting the uptake and oxidation of exogenous 1 mM palmitate. Twelve mM probenecid inhibited total oxygen consumption by 66 per cent, palmitate uptake by 43 per cent and palmitate oxidation by 87 per cent, and increased the respiratory quotient of the slices from the control value of 0·72 to 0·96. Probenecid in concentrations of 3–12 mM caused accumulation of endogenous lactate in the slices. PAH (1–9 mM) stimulated palmitate oxidation and (9 mM) the oxygen consumption of the slices, whereas the effects of PSP (0·4–3·6 mM) were negligible. The results demonstrate that probenecid stimulates anaerobic glycolysis in kidney cortex slices, and do not support the suggestion that the PAH transport system is involved in the transport of FFA in the kidney.

Neonatal ascites associated with urinary outlet obstruction (urine ascites).

Severe abdominal distention at birth is usually a serious life-threatening condition. When diagnosed in the uterine cavity before delivery the problem of soft-tissue dystocia arises (8). The etiology of an enlarged fetal abdomen in the third trimester of gestational development is usually one of the following conditions: enterogenous tumor, teratoma, polycystic kidney, neuroblastoma, Wilms's tumor, polycystic disease or large neoplasm of the liver, hydrometrocolpos, ovarian tumor, generalized edema from hemolytic disease or maternal diabetes, absence of abdominal muscles, massive hydronephrosis, or ascites (7). Ascites is the rarest etiology of a distended abdomen in the neonatal period. It is interesting to note that approximately 200 ml of fluid must be present in the peritoneal cavity before ascites becomes evident clinically. As early as 1894 Fordyce (2) published a review of fetal and neonatal ascites. Among 63 cases he collected from the literature, 17 had urinary tract abnormalities accompanied by ascites. The majority of the other cases were the result of intrauterine infectious peritonitis. Lord (5) reviewed the literature from 1903 to 1952 and found that during this period 28 additional cases of ascites were recorded, 18 of which had associated urinary outlet obstruction. The following groups of underlying abnormalities have been implicated in the pathogenesis of ascites in the neonatal period: 1. Ascites secondary to hemolytic disease 2. Peritonitis from generalized sepsis (syphilis), perforation of a hollow viscus from atresia, meconium peritonitis or other congenital abnormalities, peritonitis following ruptured ovarian cyst 3. Chylous ascites-thoracic duct obstruction 4. Portohepatic abnormalities resulting in obstruction to the venous flow, such as congenital cirrhosis of the liver, cystic disease of the liver, hypoplasia, or thrombosis of the portal vein 5. Congenital anomalies resulting in obstruction at the urinary outlet (urine ascites). The most widely accepted hypothesis of the origin of the ascitic fluid in the last group of patients has been transudation of urine from the urinary tract into the peritoneal cavity. Evidence to support this assumption has been gained by the intravenous injection of phenolsulfonphthalein (P.S.P.) and indigo carmine dyes or radioactive 131I hippuric acid (5). Following the injection, simultaneous measurements in the urine and ascitic fluid have demonstrated in some cases a rapid appearance of such tracers in the ascitic fluid. Since no direct communication from the urinary tract to the peritoneal cavity has been shown to be present, it has always been assumed that the presence of these substances in the ascitic fluid is consistent with transudation of the urine from the urinary tract. In several reported cases an open communication from the bladder to the peritoneal cavity has been proposed (1).

Phenolsulfonphthalein (PSP) in Assessment of Renal Function

Since the first report 1 of the rapid excretion of phenolsulfonphthalein (PSP) or phenol red by the kidney, PSP has been used widely to assess renal function, without serious mishap. 2 Use of the intravenous route and earlier measurement of excretion (starting at 15 minutes) have enhanced the value of the test. The mechanism of tubular excretion of PSP has been reviewed. 3 Its maximal excretory rate in man is about 36 mg/min/1.73 sq m; 50% to 60% is extracted by the kidney in one circulation, and clearance averages 400 ml/min. 4 Glomerular filtration is small compared with the amount secreted by active tubular transport. Ordinarily about 2% to 3% is excreted into the bile and limited intestinal absorption occurs. 5 Binding to albumin in vivo appears much less than the 80% suggested by studies in vitro, and some PSP appears to enter cells other than kidney, liver, and intestine.

Topical and remote effects of drugs upon tissue clearance

In the rat, various vasoconstrictors, mast-cell dischargers and mast-cell products greatly delay the absorption and increase the local spreading of intracutaneously injected phenolsulfonphthalein (PSP). In this respect the mast-cell dischargers are more effective when given systemically, the vasoconstrictors when applied topically mixed with the dye. Histamine and 5-HT occupy an intermediate position, whereas heparin is totally inert when administered by either route.

Paraplegia and Tetraplegia in CHIKUHO Labour Accident Hospital

There are 25 patients with paraplegia or tetraplegia due to trauma or orthopedic spinal diseases in CHIKUHO Labour Accident Hospital. 22 cases of them are in need of medical treatment or care, because of their paralysis or disturbance of activity of daily life. For their health control blood, urine (sediment and urinary bacterial test are involved), renal function and radiological views are regulary examined. The results of examinations for the recent eight months are summarized as follows:1. Many cases show hypochromic anemia (Hemoglobin under 90% or hematocrit under 45% are found in 72%, respectively).2. Usually, urine are acid, and leucocytes, opacity or epithelial cells are found in over 70%.3. Positive Urocheck test are obtained in 77% and positive bacterial culture are succeed in 61%. In 80%, both agree in views.4. Although 72% show under 1.018 of the maximum spcific gravity in the thirst test or hyposthenuria, the results of phenolsulfonphthalein test are almost normal.5. Regions of bony lesions have usually healed by osseous intention, but one case shows complete ankylosing spondilitis.Cystograms are revealed: the reflux in three of 16 cases (two are unilateral and one is bilateral), Schramm's phenomen in 11 of 16 cases and the beam-formation or diverticulum in 10 of 16 cases.In the intervenous pyelogram, caliectasis and ureteral dilatation are impotant.Paranephritic abscess and intermittent hydronephrosis with floating kidney have need of urologist's advice.

Phenolsulfonphthalein Excretion Tests

To the Editor:— Phenolsulfonphthalein (PSP) excretion tests were discussed inThe Journal( 195 : 1078, 1966). I recently reevaluated this subject ( Arch Int Med 117 :74, 1966). The amount of dye excreted by the kidney in the first 15 minutes after its intravenous administration is a good index of renal tubular function. However, the voided specimen at 15 minutes may not reflect the renal function. Decreased dye in that specimen can be due to incomplete bladder emptying or a slow rate of urine formation. Incomplete bladder emptying can be detected by finding decreased dye excretion in the first 15-minute specimen and normal excretion in one or two hours. (PSP, not promptly excreted by the kidneys, [1] is excreted by the liver and [2] diffuses out of the plasma. With the falling plasma level, progressively less dye is available for renal excretion.) The reason for having the patient empty his bladder before

Phenolsulfonphthalein Excretion for Estimating Residual Urine

SIGNIFICANT quantities of residual urine are conducive to urinary-tract infection. Retention of this pool of urine also makes treatment of the infection difficult, and predisposes to reinfection. At times, there is a reluctance or a relative contraindication to use of a catheter simply to determine the quantity of residual urine. Phenolsulfonphthalein (PSP) excretion can be used, without catheterization, to screen patients for residual urine and by modifying the method can measure the volume of residual urine. The fractional PSP excretion test is widely used to assess renal function. In this test, urine collections are made 15, 30, and 60 minutes after the dye is given. Since the rate of dye excretion by the kidney steadily decreases, the amount of dye in the urine collections should also decrease. If it does not, it is an indication of clinically significant residual urine. If a known amount of dye is added to an

A comparative evaluation of the phenolsulfonphthalein test and the Rubin test for tubal patency

A comparative evaluation of the phenolsulfonphthalein test and the Rubin test for tubal patency

URICOSURIC AGENTS AND PHENOLSULFONPHTHALEIN EXCRETION.

Introduction At the time of his historic discovery of hyperuricemia in gout, A. B. Garrod stated that Gout would thus appear, at least partly, to depend on a loss of power (temporary or permanent) in the uric acid-excreting function of the kidneys.1Thus began a century of interest and controversy over the role of the kidney in the pathogenesis of gout. The fact that renal mechanisms, as well as metabolic considerations, are important in some cases of gout has been demonstrated by several investigators and accepted by most workers in the field.2In addition, the kidney is one of the major sites for the deposition of uric acid crystals.3-6Nonspecific findings such as proteinuria, a decrease in the ability of the kidney to concentrate the urine, and a decrease of phenolsulfonphthalein (PSP) excretion by the kidney are the early manifestations of this derangement. In recent years uricosuric

Theoretical Analysis of Phenolsulfonphthalein Test anb its Clinical Applications

Theoretical Analysis of Phenolsulfonphthalein Test anb its Clinical Applications