Hostname: page-component-7bb8b95d7b-5mhkq Total loading time: 0 Render date: 2024-09-15T00:34:56.890Z Has data issue: false hasContentIssue false
  • English
  • Français

Nutrition in Renal Failure

Published online by Cambridge University Press:  14 December 2007

H. A. Lee  and
S. T. Talbot
H. A. Lee
Affiliation:
Department of Renal Medicine, University of Southampton, St Mary's Hospital, Milton Road, Portsmouth PO3 6AD
S. T. Talbot
Affiliation:
Department of Renal Medicine, University of Southampton, St Mary's Hospital, Milton Road, Portsmouth PO3 6AD
Rights & Permissions [Opens in a new window]

Abstract

An abstract is not available for this content so a preview has been provided. As you have access to this content, a full PDF is available via the ‘Save PDF’ action button.
Image of the first page of this content. For PDF version, please use the ‘Save PDF’ preceeding this image.'
Type
Research Article
Information
Nutrition Research Reviews , Volume 2 , Issue 1 , January 1989 , pp. 1 - 16
Copyright
Copyright © The Nutrition Society 1989

References

REFERENCES

Abel, R. M., Beck, C. H., Abbott, W. M., Ryan, J. A., Barnett, G. O. & Fischer, J. E. (1973). Improved survival from acute renal failure after treatment with intravenous essential L-amino acids and glucose. New England Journal of Medicine 288, 696–699.CrossRefGoogle ScholarPubMed
Albers, S., Wernerman, J., Stehle, P., Vinnars, E. & Furst, P. (1988). Availability of amino acids supplied intravenously in healthy man as synthetic dipeptides: kinetic evaluation of L-alanyl-L-glutamine and glycyl-L-tyrosine. Clinical Science 75, 463–468.CrossRefGoogle Scholar
Alvestrand, A., DeFronzo, R. A., Smith, D. & Wahren, J. (1988). Influence of hyperinsulinaemia on intracellular amino acid levels and amino acid exchange across splanchnic and leg tissues in uraemia. Clinical Science 74, 155–163.CrossRefGoogle ScholarPubMed
Alvestrand, A., Furst, P. & Bergstrom, J. (1983). Intracellular amino acids in uremia. Kidney International 24, Suppl. 16, S-9–S-16.Google Scholar
Ang, S. D., Leskiw, M. J. & Stein, T. P. (1983). The effect of increasing total parenteral nutrition on protein metabolism. Journal of Parenteral and Enteral Nutrition 7, 525–529.CrossRefGoogle ScholarPubMed
Arisi, L., Garini, G., Paganelli, E. & Franco, V. (1989). Blunting of dialysis-induced hypercatabolism (DIHC) by indomethacin (I). Kidney International (abstr., in the press).Google Scholar
Arnold, W. C. & Holliday, M. A. (1979). Tissue resistance to insulin stimulation of amino acid uptake in acutely uraemic rats. Kidney International 16, 124–129.CrossRefGoogle Scholar
Askanazi, J., Carpentier, Y. A., Elwyn, D. H., Nordenstrom, J., Jeevanandam, M., Rosenbaum, S. H., Gump, F. E., Facs, M. D. & Kinney, J. M. (1980 a). Influence of total parenteral nutrition on fuel utilisation in injury and sepsis. Annals of Surgery 191, 40–46.CrossRefGoogle ScholarPubMed
Askanazi, J., Carpentier, Y. A., Michelsen, C. B., Elwyn, D. H., Furst, P., Kantrowitz, L. R., Gump, F. E. & Kinney, J. M. (1980 b). Muscle and plasma amino acids following injury: influence of intercurrent infection. Annals of Surgery 192, 78–85.CrossRefGoogle ScholarPubMed
Baek, S. M., Makaboli, G. G., Bryan-Brown, C. W., Kusek, J. & Shoemaker, W. C. (1975). The influence of parenteral nutrition on the course of acute renal failure. Surgery, Gynecology and Obstetrics 141, 405–408.Google ScholarPubMed
Baracos, V., Rodemann, H. P., Dinarello, C. A. & Goldberg, A. L. (1983). Stimulation of muscle protein degradation and prostaglandin E2 release by leukocytic pyrogen (interleukin- 1). A mechanism for the increased degradation of muscle proteins during fever. New England Journal of Medicine 308, 553–558.CrossRefGoogle ScholarPubMed
Beisel, W. R., Sawyer, W. D., Ryll, E. D. & Crozier, D. (1967). Metabolic effects of intracellular infections in man. Annals of Internal Medicine 67, 744–779.CrossRefGoogle ScholarPubMed
Berlyne, G. M., Bazzard, F. J., Booth, E. M., Janabi, K. & Shaw, A. B. (1967). The dietary treatment of ARF. Quarterly Journal of Medicine 36, 59–83.Google Scholar
Bilbrey, G. L., Faloona, G. R., White, M. G. & Knochel, J. P. (1974). Hyperglucagonemia of renal failure. Journal of clinical Investigation 53, 841–847.CrossRefGoogle ScholarPubMed
Bingel, M., Lonnemann, G., Koch, K. M., Dinarello, C. A. & Shaldon, S. (1987). Enhancement of in-vitro human interleukin- 1 production by sodium acetate. Lancet i, 14–16.CrossRefGoogle Scholar
Bingel, M., Lonnemann, G., Shaldon, S., Koch, K. M. & Dinarello, C. A. (1986). Human interleukin- 1 (IL-1) production during haemodialysis. Nephron 43, L161–163.CrossRefGoogle Scholar
Bistrian, B. R. (1979). A simple technique to estimate severity of stress. Surgery, Gynecology and Obstetrics 148, 675–678.Google ScholarPubMed
Bondy, P. K., Engel, F. L. & Farrar, B. (1949). The metabolism of amino acids and protein in the adrenalectomized-nephrectomized rat. Endocrinology 44, 476–483.CrossRefGoogle Scholar
Borst, J. G. G. (1948). Protein catabolism in uraemia. Effects of protein-free diet, infections, and blood transfusions. Lancet i, 824–828.CrossRefGoogle Scholar
Brenner, B. M., Meyer, T. W. & Hostetter, T. H. (1982). Dietary protein intake and the progressive nature of renal disease. New England Journal of Medicine 307, 652–659.Google ScholarPubMed
Brissac, C., Saint-Aubert, B., Joyeux, A., Joyeux, H. & Solassol, C. (1981). Alpha-ketoacids in acute renal insufficiency in the dog. In Metabolism and Clinical Implications of Branched Chain Amino and Ketoacids (Developments in Biochemistry Series, vol. 18), pp. 599–604. (Walser, M. and Williamson, J. R., editors). Amsterdam: Elsevier/North-Holland.Google Scholar
Brooks, D. C., Bessey, P. Q., Black, P. R., Aoki, T. T. & Wilmore, D. W. (1984). Post-traumatic insulin resistance in uninjured forearm tissue. Journal of Surgical Research 37, 100–107.CrossRefGoogle ScholarPubMed
Bull, G. M., Jockes, J. M. & Lowe, K. G. (1949). Conservative treatment of anuric uraemia. Lancet ii, 229.CrossRefGoogle Scholar
Clark, A. S. & Mitch, W. E. (1983). Muscle protein turnover and glucose uptake in acute uremic rats. Effects of insulin and the duration of renal insufficiency. Journal of Clinical Investigation 72, 836–845.CrossRefGoogle ScholarPubMed
Conger, J. D. (1975). A controlled evaluation of prophylactic dialysis in post-traumatic acute renal failure. Journal of Trauma 15, 1056–1063.CrossRefGoogle ScholarPubMed
Cuthbertson, D. & Tilstone, W. J. (1969). Metabolism during the postinjury period. Advances in Clinical Chemistry 12, 1–55.CrossRefGoogle ScholarPubMed
Diamond, S. M. & Henrich, W. L. (1988). Nutrition and peritoneal dialysis. In Nutrition and the Kidney, pp. 198–223. (Mitch, W. E. and Klahr, S. editors) Boston, MA: Little, Brown and Company.Google Scholar
Dinarello, C. A. (1979). Production of endogenous pyrogen. Federation Proceedings 38, 52–56.Google ScholarPubMed
Dinarello, C. A. (1984). Interleukin- 1. Review of Infectious Diseases 6, 51–95.CrossRefGoogle ScholarPubMed
Dinarello, C. A. (1985). An update on human interleukin- 1: from molecular biology to clinical relevance. Journal of Clinical Immunology 5, 287–297.CrossRefGoogle ScholarPubMed
Dudrick, S. J., Steiger, E. & Long, J. M. (1970). Renal failure in surgical patients. Treatment with intravenous essential amino acids and hypertonic glucose. Surgery 68, 180–186.Google ScholarPubMed
Englert, E., Brown, H., Willardson, D., Wallach, S. & Simons, E. L. (1958). Metabolism of free and conjugated 17-hydroxycorticosteroids in subjects with uremia. Journal of Clinical Endocrinology and Metabolism 18, 36–48.CrossRefGoogle ScholarPubMed
Feinstein, E. I. (1987). Nutritional haemodialysis. Kidney International 32, Suppl. 22, S-167–S-169.Google Scholar
Feinstein, E. I., Blumenkrantz, M. J., Healy, M., Koffler, A., Silberman, H., Massry, S. & Kopple, J. D. (1981). Clinical and metabolic responses to parenteral nutrition in acute renal failure. A controlled double-blind study. Medicine 60, 124–137.CrossRefGoogle ScholarPubMed
Feinstein, E. I., Kopple, J. D., Silberman, H. & Massry, S. G. (1983). Total parenteral nutrition with high or low nitrogen intakes in patients with acute renal failure. Kidney International 16, Suppl., S-319–S-323.Google ScholarPubMed
Fröhlich, J., Schölmerich, J., Hoppe-Seyler, G., Maier, K. P., Talke, H., Schollmeyer, P. & Gerok, W. (1974). The effect of acute uremia on gluconeogenesis in isolated perfused rat livers. European Journal of Clinical Investigation 4, 453–458.CrossRefGoogle ScholarPubMed
Fulks, R. M., Li, J. B. & Goldberg, A. L. (1975). Effects of insulin, glucose and amino acids on protein turnover in rat diaphragm. Journal of Biological Chemistry 250, 290–298.CrossRefGoogle ScholarPubMed
Furst, P., Albers, S. & Stehle, P. (1989). Evidence for a nutritional need for glutamine (Gln) in catabolic patients. Kidney International (In the press).Google Scholar
Garber, A. J. (1978). Skeletal muscle protein and amino acid metabolism in experimental chronic uraemia in the rat: accelerated alanine and glutamine formation and release. Journal of Clinical Investigation 62, 623–632.CrossRefGoogle ScholarPubMed
Goldberg, A. L. & Tischler, M. E. (1981). Regulatory effects of leucine on carbohydrate and protein metabolism. In Metabolism and Clinical Implications of Branched Chain Amino and Ketoacids (Developments in Biochemistry Series, vol. 18), pp. 205–216. (Walser, M. and Williamson, J. R., editors) Amsterdam: Elsevier/North-Holland.Google Scholar
Greig, P. D., Elwyn, D. H., Askanazi, J. & Kinney, J. M. (1987). Parenteral nutrition in septic patients: effect of increasing nitrogen intake. American Journal of Clinical Nutrition 46, 1040–1047.CrossRefGoogle ScholarPubMed
Gretz, N., Korb, E. & Strauch, M. (1983). Low-protein diet supplemented by ketoacids in chronic renal failure. Kidney International 24, Suppl. 16, S-263.Google Scholar
Harter, H. R., Karl, I. E., Klahr, S. & Kipnis, D. M. (1979). Effects of reduced renal mass and dietary protein intake on amino acid release and glucose uptake by rat muscle in vitro. Journal of Clinical Investigation 64, 513–523.CrossRefGoogle ScholarPubMed
Iapichino, G., Radrizzani, D., Solca, M., Pesenti, A., Gattinoni, L., Ferro, A., Leoni, L., Langer, M., Vesconi, S. & Damia, G. (1984). The main determinants of nitrogen balance during total parenteral nutrition in critically ill injured patients. Intensive Care Medicine 10, 251–254.CrossRefGoogle ScholarPubMed
Kahn, C. R. (1978). Insulin resistance, insulin sensitivity and insulin unresponsiveness: a necessary distinction. Metabolism 27, Suppl. 2, 1893–1902.CrossRefGoogle ScholarPubMed
Kapadia, C. R., Muhlbacher, F., Smith, R. J. & Wilmore, D. W. (1982). Alteration in glutamine metabolism in response to operative stress and food deprivation. Surgical Forum 33, 19–21.Google Scholar
Kleinknecht, D., Jungers, P., Chanard, J., Barbanel, C. & Ganevel, D. (1972). Uraemic and non-uraemic complications in acute renal failure: evaluation of early and frequent dialysis on prognosis. Kidney International 1, 190–196.CrossRefGoogle Scholar
Kokot, F. & Kuska, J. (1973). Influence of extracorporeal dialysis on glucose utilisation and insulin secretion in patients with acute renal failure. European Journal of Clinical Investigation 3, 105–111.CrossRefGoogle ScholarPubMed
Kramer, P., Bohler, J., Kehr, A., Greone, H. J., Schrader, J., Mathei, D. & Scheler, F. (1982). Intensive care potential of continuous arteriovenous haemofiltration. Transactions of the American Society of Artificial Internal Organs 28, 29–33.Google Scholar
Lee, H. A. (1978). The nutritional management of renal disease. In Nutrition in the Clinical Management of Disease, pp. 262–279 (Dickerson, J. W. T. and Lee, H. A. editors). London: Edward Arnold.Google Scholar
Lee, H. A., Hadfield, C. M. I., Talbot, S. T. & Jackson, J. M. (1987). Dialamine (R) (Essential amino acid powder) as a supplement to low protein diets in advanced chronic renal failure. Clinical Nutrition 6, 111–116.CrossRefGoogle Scholar
Lee, H. A. & Jackson, M. A. (1981). Ketoacid therapy in chronic renal failure patients on moderately protein-restricted diets. In Pathophysiology of Patients Treated for 10 Years or More. (Giordano, C. and Friedman, E. A., editors) Milan, Wichtig Editore.Google Scholar
Lee, H. A. & Talbot, S. T. (1989). Nutrition in acute renal failure. Update (In the press).Google ScholarPubMed
Lee, H. A., Talbot, S. T., Rowlands, A. & Jackson, M. A. (1980). Dietary management of chronic renal failure with oral amino acids. Nutrition and Metabolism 24, 50–63.CrossRefGoogle ScholarPubMed
Long, C. L., Haverberg, L. N., Young, V. R., Kinney, J. M., Munro, H. N. & Geiger, J. W. (1975). Metabolism of 3-methylhistidine in man. Metabolism 24, 929–935.CrossRefGoogle ScholarPubMed
Marliss, E. B., Aoki, T. T., Unger, R. H., Soeldner, J. S. & Cahill, G. F. (1970). Glucagon levels and metabolic effects in fasting man. Journal of Clinical Investigation 49, 2256–2270.CrossRefGoogle ScholarPubMed
Maschio, G., Oldrizzi, R., Tessitore, N., D'Angelo, A., Valvo, E., Lupo, A., Loschiavo, C., Fabris, A., Gammaro, L., Rugiu, C. & Panzetta, G. (1982). Effects of dietary protein and phosphorus restriction on the progression of early renal failure. Kidney International 22, 371–376.CrossRefGoogle ScholarPubMed
May, R. C., Clark, A. S., Goheer, M. A. & Mitch, W. E. (1985). Specific defects in insulin-mediated muscle metabolism in acute uremia. Kidney International 28, 490–497.CrossRefGoogle ScholarPubMed
Mirtallo, J. M. & Fabri, P. J. (1984). Effect of nitrogen intake on urea appearance in patients receiving total parenteral nutrition and hemodialysis. Drug Intelligence and Clinical Pharmacy 18, 612–616.CrossRefGoogle ScholarPubMed
Mitch, W. E. (1988). Nutritional therapy and the progression of renal insufficiency. (1988). In Nutrition and the Kidney, pp. 154–179 (Mitch, W. E. and Klahr, S., editors) Boston, MA: Little, Brown and Company.Google Scholar
Mitch, W. E., Abras, E. & Walser, M. (1982). Long-term effects of a new keto acid-amino acid supplement in patients with chronic renal failure. Kidney International 22, 48–53.CrossRefGoogle ScholarPubMed
Mitch, W. E., Walser, M. & Sapir, D. G. (1981). Nitrogen sparing induced by leucine compared with that induced by its keto analogue, α-ketoisocaproate, in fasting, obese man. Journal of Clinical Investigation 67, 553–562.CrossRefGoogle ScholarPubMed
Mondon, C. E., Dolkas, C. B. & Reaven, G. M. (1978). The site of insulin resistance in acute uraemia. Diabetes 27, 571–576.CrossRefGoogle Scholar
Muhlbacher, F., Kapadia, C. R., Colpoys, M. F., Smith, R. J. & Wilmore, D. W. (1984). Effects of glucocorticoids on glutamine metabolism in skeletal muscle. American Journal of Physiology 247, E75–E83.Google ScholarPubMed
Nishizawa, N., Shimbo, M., Noguchi, T., Hareyama, S. & Funabiki, R. (1978). Effect of starvation, refeeding and hydrocortisone administration on turnover of myofibrillar proteins estimated by urinary excretion of N′-methylhistidine in the rat. Agricultural and Biological Chemistry 42, 2083–2089.Google Scholar
Paganini, E. P., Flaque, J., Whitman, G. & Nakamoto, S. (1982). Amino acid balance in patients with oliguric acute renal failure undergoing slow continuous ultrafiltration (SCUF). Transactions of the American Society of Artificial Internal Organs 28, 615–620.Google ScholarPubMed
Pelosi, G., Proietti, R., Arcangeli, A., Magalini, S. I. & Bondoli, A. (1981). Total parenteral nutrition infusate. An approach to its optimal composition in post-trauma acute renal failure. Resuscitation 9, 45–51.CrossRefGoogle ScholarPubMed
Persike, E. C. & Addis, T. (1949). Increased rate of urea formation following removal of renal tissue. American Journal of Physiology 158, 149–156.CrossRefGoogle ScholarPubMed
Port, F. K., VanDeKerkhove, K. M., Kunkel, S. L. & Kluger, M. J. (1987). The role of dialysate in the stimulation of interleukin- 1 production during clinical haemodialysis. American Journal of Kidney Diseases 10, 118–122.CrossRefGoogle Scholar
Proietti, R., Pelosi, G., Santori, R., Giammaria, A., Arcangeli, A., Sciarra, M. & Zanghi, F. (1983). Nutrition in acute renal failure. Resuscitation 10, 159–166.CrossRefGoogle ScholarPubMed
Radrizzani, D., Iapichino, G., Scherini, A., Ferrero, P., Doldi, S. B., Solca, M., Colombo, A., Leoni, L. & Damia, G. (1986). Main nitrogen balance determinants in malnourished patients. Intensive Care Medicine 12, 308–311.CrossRefGoogle ScholarPubMed
Rainford, D. J. (1981). Nutritional management of acute renal failure. Acta Chirurgica Scandinavica 507, Suppl., 327–329.Google ScholarPubMed
Rainford, D. J. (1987). Trends in management of acute renal failure. In Renal Failure: Current Approaches. pp. 26–30. (Lee, H. A. and Parker, S. W. editors). Southampton: Duphar Medical Laboratories Ltd.Google Scholar
Rosman, J. B. (1984). Prospective randomised trial of early dietary protein restriction in chronic renal failure. Lancet ii, 1291–1292.CrossRefGoogle Scholar
Roth, E., Funovics, J., Muhlbacher, F., Schemper, M., Mauritz, W., Sporn, P. & Fritsch, A. (1982). Metabolic disorders in severe abdominal sepsis: glutamine deficiency in skeletal muscle. Clinical Nutrition 1, 25–41.CrossRefGoogle ScholarPubMed
Roulet, M., Detsky, A. S., Marliss, E. B., Todd, T. R. J., Mahon, W. A., Anderson, G. H., Stewart, S. & Jeejeebhoy, K. N. (1983). A controlled trial of the effect of parenteral nutritional support on patients with respiratory failure and sepsis. Clinical Nutrition 2, 97–105.CrossRefGoogle ScholarPubMed
Sapir, D. G. & Walser, M. (1977). Nitrogen-sparing induced early in starvation by infusion of branched-chain ketoacids. Metabolism 26, 301–308.CrossRefGoogle ScholarPubMed
Schaefer, R. M., Teschner, M., Riegel, W. & Heidland, A. (1989). Reduced hepatic glucose and urea genesis by the antiglucocorticoid RU 38486 in acutely uraemic rats. Kidney International (In the press).Google Scholar
Schaefer, R. M., Weipert, J., Moser, M., Peter, G., Heidbreder, E., Horl, W. H. & Heidland, A. (1988). Reduction of urea generation and muscle protein degradation by adrenalectomy in acutely uremic rats. Nephron 48, 149–153.CrossRefGoogle ScholarPubMed
Shizgal, H. M. & Forse, R. H. (1980). Protein and caloric requirements with total parenteral nutrition. Annals of Surgery 192, 562–568.CrossRefGoogle ScholarPubMed
Souba, W. W. & Wilmore, D. W. (1983). Postoperative alteration of arterio-venous exchange of amino acids across the gastrointestinal tract. Surgery 94, 342–350.Google Scholar
Spreiter, S. C., Myers, B. D. & Swenson, R. S. (1980). Protein-energy requirements in subjects with acute renal failure receiving intermittent hemodialysis. American Journal of Clinical Nutrition 33, 1433–1437.CrossRefGoogle ScholarPubMed
Talbot, S. T., Venkat Raman, G. & Lee, H. A. (1989 a). Nitrogen requirements in acute renal failure. Kidney International (In the press).Google Scholar
Talbot, S. T., Venkat Raman, G. & Lee, H. A. (1989 b). The catabolic effect of haemodialysis in the management of acute renal failure. Kidney International (In the press).Google Scholar
Teschan, P. E., Baxter, C. R., O'Brien, T. F., Freyhof, J. N. & Hall, W. H. (1960). Prophylactic haemodialysis in the treatment of acute renal failure. Annals of Internal Medicine 53, 992–1016.Google ScholarPubMed
Walls, J. (1987). Dietary influences on renal failure. In Renal Failure: Current Approaches, pp. 13–17. (Lee, H. A. and Parker, S. W., editors) Southampton; Duphar Laboratories Ltd.Google Scholar
Ward, R. A., Shirlow, M. J., Hayes, J. M., Chapman, G. V. & Farrell, P. C. (1979). Protein catabolism during hemodialysis. American Journal of Clinical Nutrition 32, 2443–2449.CrossRefGoogle ScholarPubMed
Wilmore, D. W. (1976). Carbohydrate metabolism in trauma. Clinical Endocrinology and Metabolism 5, 731–745.CrossRefGoogle ScholarPubMed
Wilmore, D. W. (1977 a). The Metabolic Management of the Critically Ill. New York: Plenum Press.CrossRefGoogle Scholar
Wilmore, D. W. (1977 b). Energy requirements for maximum nitrogen retention. In Symposium on Amino Acid Metabolism, pp. 47–57 (Green, H. L., Halliday, M. A. and Munro, H. N. editors). Chicago, IL: American Medical Association.Google Scholar
Wilmore, D. W., Goodwin, G. W., Aulick, L. H., Powanda, M. C., Mason, A. D. & Pruitt, B. A. (1980). Effect of injury and infection on visceral metabolism and circulation. Annals of Surgery 192, 491–504.CrossRefGoogle ScholarPubMed
Wolfe, R. R., Goodenough, R. D., Burke, J. F. & Wolfe, M. H. (1983). Protein dynamics in stress. In: Amino Acids: Metabolism and Medical Applications, pp. 396–400 (Blackburn, G. L., Grant, J. P. and Young, V. R., editors). Boston: John Wright.Google Scholar
Wolfson, M., Jones, M. R. & Kopple, J. D. (1982). Amino acid losses during haemodialysis with infusion of amino acids and glucose. Kidney International 21, 500–506.CrossRefGoogle ScholarPubMed
Wool, I. G. (1969). Insulin and amino acid transport in muscle. In Protein and Polypeptide Hormones, International Congress Series no. 161, pp. 285–295. (Margoulies, M., editor) Amsterdam: Excerpta Medica Foundation.Google Scholar
Woolfson, A. M. J., Heatley, R. V. & Allison, S. P. (1979). Insulin to inhibit protein catabolism after injury. New England Journal of Medicine 300, 14–17.CrossRefGoogle ScholarPubMed
Yang, R. D., Sakamoto, A., Moldawer, L. L., Young, V. R., Wannemacher, R. W., Blackburn, G. L. & Bistrian, B. R. (1981). Stress induced changes in protein metabolism: the effect of leukocyte endogenous mediator (LEM) in the rat. Federation Proceedings 40, 901 (Abstr. no. 3809).Google Scholar