The effect of low molecular weight dextran (LMWD) on the renal hemodynamics

摘要

LMWD has been widely used because of its benefic i ale ffects of antisludging and disaggregation. Urologists has also interested in the plasma expander, because the recent progress of the urological surgery has become to require a large volume of blood transfusion. The best plasma expander in the field of urology must be the o ne not only to maintain the blood pressure and the circulation volume, but also to have a good effect on the renal function. The purpose of the following experimental and clinical studies is to evaluate the effect of LMWD on the renal hemodynamics. Experimental s tu d y : 1) The response of LMWD( Dextron and Dextron A) on the renal function was studied in 24 anesthetized mongrel dogs. 2) After bleeding of 2 % body weight, the same volune of the blood or LMWDw as transfused intravenously. Before and after transfusion, urine volume, urine osmolarity, serum electrolyte, hematocrit, systemic blood pressure, renal perfusion pressure, urea index, direct renal blood flow, PAH clearance and inulin clearance were measured. 3) LMWD was transiently as effective as the blood to maintain the systemic blood pressure and the circulation volume. LMWD was more effective than the blood on recovery of the renal function. 4) Change of the serum electrolyte was negligible, and the use of mannitol after transfusion of LMWD was more effective. Clinicals tudy : During and af t er various urologicals urgical procedures (temporary ischemic kidneys ; 4 cases, the others ; 24 cases), before and after translumbar aortographies (10 cases), and as the extracorporal circulation of the hemodialysis, LMWD was infused and renal function was measured. LMWD had good effect on the clinical renal function. LMWDi s a just suitable plasma expander in urolog y .