Xenon transit through the oliguric human kidney: Analysis by maximum likelihood

Hollnberg, Norman K.; Sandor, Tamas; Conroy, Margaret; Adams, Douglass F.; Solomon, Harold S.; Abrams, Herbert L.; Merrill, John P.
January 1973
Kidney International;Jan1973, Vol. 3 Issue 1, p177
Academic Journal
The method of maximum likelihood has been used to analyze xenon transit through the kidney in normal man and patients with acute oliguric renal failure. Xenon transit was assessed by injection of indicator into the renal artery and external counting. Maximum likelihood provided not only a statistically "best" solution but also much greater resolution of exponential functions with similar t½ than graphical techniques permit. The analysis has provided strong evidence for a marked reduction in the flow rate of the most rapid —or cortical — flow component in acute oliguric states. In normal subjects this flow rate by computer analysis ranged from 277 to 581 (mean: 426 ml/100 g/min), and it showed a striking concordance with values derived from graphical analysis. In patients with acute renal failure neither a shunt nor an early rapid component was found by computer analysis: flow ranged from 90 to 159 ml/100 g/min. An additional exponential function was identified in two patients under special circumstances. The increase in cortical vascular resistance in patients with acute renal failure is sufficient to account for the failure of function. Furthermore, cortical flow is reduced to levels which normally characterize medullary perfusion, a larger flow reduction than suggested by earlier analyses.


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