Advertisement

Experimental and clinical studies on renal disturbance in obstructive jaundice

  • Kenji Koyama
  • Kenji Ito
  • Hisami Fukaya
  • Kenji Okabe
  • Toshio Sato
Original Articles

Abstract

Renal functions and the clinical courses of 14 patients with renal disturbances associated with obstructive jaundice were studied. All patients had high concentrations of serum bilirubin, long durations of jaundice and episodes of shock due to massive hemorrhage or severe inflammation. In an experimental study on jaundiced rats, effects of hypotension or bilateral renal antery occlusion on renal function and renal cortical mitochondrial respiration at 1 week, 3 or 6-weeks after biliary obstruction were investigated. In jaundiced rats, there was no remarkable difference in renal function, but the renal mitochondrial respiration indices decreased with prolongation of the biliary obstruction. In hypotensive rats with prolonged biliary obstruction, the mitochondrial function was impaired, and in the rats with renal artery occlusion, the mitochondrial impairment was more severe. Based on these clinical and experimental data, it is tentatively suggested that patients with prolonged jaundice should be considered in a prodromal state of renal failure and that any minute circulatory failure may induce acute renal failure.

Key Words

renal failure obstructive jaundice renal mitochondria ATP hypotension 

References

  1. 1.
    Oliver, J.: The pathogenesis of acute renal failure associated with traumatic and toxic injury: Renal ischemia, nephrotoxic damage, and the ischemic episode. J. Clin. Invest. 30: 1307–1351, 1961.Google Scholar
  2. 2.
    Hogeboom, G.H. & Schneider, W.C.: Isolation of intact mitochondria from rat liver. J. Biol. Chem. 172: 619–630, 1948.PubMedGoogle Scholar
  3. 3.
    Hagihara, B.: Techniques for the application of polarogaaphy to mitochondrial respiration. Biochim. Biophys. Acta 46: 134–142, 1961.PubMedCrossRefGoogle Scholar
  4. 4.
    Koyama, K., Ito, K., Ouchi, K., Sato, T.: Mitochondrial function of rat liver in biliary obstruction. Tohoku J. Exp. Med. 131: 59–69, 1980.PubMedCrossRefGoogle Scholar
  5. 5.
    Chance, B. & Williams, G.R.: Respiratory enzymes in oxidative phosphorylation. II. difference spectra. J. Biol. Chem. 217: 395–407, 1955.PubMedGoogle Scholar
  6. 6.
    Dawson, J.L.: Acute postoperative renal failure in obstructive jaundice. Ann. Roy. Coll. Surg. Engl. 42: 163–181, 1968.Google Scholar
  7. 7.
    Aylward, T.D., Scowengerdt, C.G. and Bove, K.: Experimental hyperbilirubinemia: effect on glomerular filtration. J. Surg. Res. 15: 1–3, 1973.PubMedCrossRefGoogle Scholar
  8. 8.
    Ozawa, K., Kitamura, O., Yamaoka, Y., Mizukami, T., Kamano, T., Tekeda, H., Takasan, H. & Honjo, I. Role of portal blood on the enhancement of liver mitochondrial metabolism. Amer. J. Surg. 124: 16–20, 1972.PubMedCrossRefGoogle Scholar
  9. 9.
    Zetterstrom, R. & Ernster, L.: Bilirubin, an uncoupler of oxidative phosphorylation in isolated mitochondria. Nature 178: 1335–1337, 1956.PubMedCrossRefGoogle Scholar
  10. 10.
    Mustafa, M.G., Cowger, M.L. & King, T.E.: Effects of bilirubin on mitochondrial reactions. J. biol. Chem. 244: 6403–6414, 1969.PubMedGoogle Scholar
  11. 11.
    Kessler, R.H.: The effect of metabolic inhibitors and diuretics on sodium chloride reabsorption and oxidative metabolism in the mammalian kidney. Ann. N.Y. Acad. Sci. 139: 356–361, 1966.PubMedGoogle Scholar
  12. 12.
    Williams, R.D.: The effect of hypotension in obstructive jaundice. Arch. Surg. 81: 334–340, 1960.PubMedGoogle Scholar

Copyright information

© The Japan Surgical Society 1981

Authors and Affiliations

  • Kenji Koyama
    • 1
  • Kenji Ito
    • 1
  • Hisami Fukaya
    • 1
  • Kenji Okabe
    • 1
  • Toshio Sato
    • 1
  1. 1.Department of SurgeryFohoku University Faculty of MedicineSendaiJapan

Personalised recommendations