AIM: We have studied 160 children with a variety of renal diseases, 14 of them with chronic renal failure (CRF), to evaluate maximum urinary osmolality as a predictor of glomerular filtration rate (GFR) testing the hypothesis that a normal GFR is necessary to have a normal urinary concentrating capacity. METHODS: All patients had a serum creatinine measured. GFR was calculated according to the Schwartz formula. All patients underwent desmopressin (DDAVP) test to evaluate renal concentrating capacity. RESULTS: Patients with CRF were unable to concentrate the urine beyond 486 mosm/kg whereas all patients with a normal concentrating capacity (urine osmolality >835 mosm/kg) had a normal GFR. Desmopressin test sensitivity to detect CRF was 100% and specificity 70.5%. A significant negative correlation was found between urinary osmolality after DDAVP administration and serum creatinine levels and between urinary volume corrected by 100 mL of GFR (V/GFR) and urinary osmolality. CONCLUSION: In our series, a normal concentrating capacity was always associated with a normal GFR while all patients with decreased GFR had a concentrating capacity defect. Thus, in the evaluation of infants and children with renal disease, the finding of a normal urinary concentrating capacity will suggest and intact glomerular and tubular function.
AIM: We have studied 160 children with a variety of renal diseases, 14 of them with chronic renal failure (CRF), to evaluate maximum urinary osmolality as a predictor of glomerular filtration rate (GFR) testing the hypothesis that a normal GFR is necessary to have a normal urinary concentrating capacity. METHODS: All patients had a serum creatinine measured. GFR was calculated according to the Schwartz formula. All patients underwent desmopressin (DDAVP) test to evaluate renal concentrating capacity. RESULTS:Patients with CRF were unable to concentrate the urine beyond 486 mosm/kg whereas all patients with a normal concentrating capacity (urine osmolality >835 mosm/kg) had a normal GFR. Desmopressin test sensitivity to detect CRF was 100% and specificity 70.5%. A significant negative correlation was found between urinary osmolality after DDAVP administration and serum creatinine levels and between urinary volume corrected by 100 mL of GFR (V/GFR) and urinary osmolality. CONCLUSION: In our series, a normal concentrating capacity was always associated with a normal GFR while all patients with decreased GFR had a concentrating capacity defect. Thus, in the evaluation of infants and children with renal disease, the finding of a normal urinary concentrating capacity will suggest and intact glomerular and tubular function.
Authors: Sarah L Walton; Reetu R Singh; Melissa H Little; Josephine Bowles; Joan Li; Karen M Moritz Journal: J Physiol Date: 2018-07-05 Impact factor: 5.182
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Authors: Paulo Cesar Koch Nogueira; Tulio Konstantyner; Maria Fernanda Camargo de Carvalho; Cristine Campos de Xavier Pinto; Isabel de Pádua Paz; Vera Maria Santoro Belangero; Marcelo de Sousa Tavares; Clotilde Druck Garcia; Oreste Angelo Ferra Neto; Káthia Liliane da Cunha Ribeiro Zuntini; Marina da Rocha Lordelo; Samira Shizuko Parreao Oi; Renata Trindade Damasceno; Ricardo Sesso Journal: PLoS One Date: 2019-04-19 Impact factor: 3.240
Authors: Emily S Dorey; Sarah L Walton; Jacinta I Kalisch-Smith; Tamara M Paravicini; Emelie M Gardebjer; Kristy A Weir; Reetu R Singh; Helle Bielefeldt-Ohmann; Stephen T Anderson; Mary E Wlodek; Karen M Moritz Journal: Physiol Rep Date: 2019-11