下部尿路通過障害時の腎機能について

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概要

• 論文の詳細を見る

• 1) In an attempt to study the behavior of the cortical and medullar function of the kidney in lower urinary tract obstruction we assessed the glomerular function by C_<STS>, the proximal tubular function by C_<PAH>, and the medullar function by urine osmolarity at antidiuresis in a total of 47 such cases. In the present paper was described chiefly the medullar function under such clinical circumstances and at the same time were mentioned alterations in it after relief of the obstruction. 2) The overwhelming majority of patients with lower urinary tract obstruction so far experienced by us are aged and the role played by advancing age in the development of impairment of the renal function in these cases seems to be by no means insignificant, accordingly. 3) In 53% of our series there was impairment of the medullar function noted, which indicates that lower urinary tract obstruction may affect the medullar function greatly on many occasions. 4) Lower urinary tract obstruction impairs the medullar, proximal tubular, and glomerular function successively in that order and it is mandatory to determine the urine concentrating ability in each patient. 5) Functional disorders of the kidney seen in lower urinary tract obstruction with the predominance of diminished concentrating ability are due greatly to urinary tract infection. 6) Following surgical relief of lower urinary tract obstruction the medullar function reduces markedly for a while and then returns gradually to the normal in the course of above 6 months in cases whose urine osmolarity at antidiuresis exceeds 500mOsm/kg H_2O preoperatively. Its recovery is poor if the preoperative urine osmolarity is less than 500 mOsm/kg H_2O, the eflfect of surgical intervention manifesting itself more conspicuously. 7) From the above described it follows that patients with lower urinary tract obstruction need be subjected to operation for its relief prior to the development of a high degree of medullar insufficiency and by doing so it may be anticipated to achieve recovery of the impaired renal function.

• 千葉大学の論文

著者

• 瀬川 襄

  千葉大学医学部泌尿器科

• 瀬川 襄

  千葉大学医学部泌尿器科学教室

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