Four Ways to Recruit Renal Functional Reserve

Mansy, Hatem; Patel, D.J.; Tapster, S.; Torrance, A.; Wilkinson, Robert W.

doi:10.1042/cs069012p

Cited by 19 publications

(25 citation statements)

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“…The limited size of the validation cohort could explain why age was not inversely associated with the functional gain in this cohort. It would have been of interest to study the association between rk-GFR/vol and the measured functional reserve using amino acids infusion (32), because this may have power to predict the functional gain. However, it must be kept in mind that long-term GFR increase after kidney donation probably depends on the initial renal functional reserve and also, the compensatory hypertrophy of the remaining kidney.…”

Section: Discussionmentioning

confidence: 99%

Association of mGFR of the Remaining Kidney Divided by Its Volume before Donation with Functional Gain in mGFR among Living Kidney Donors

Courbebaisse¹,

Tissier²,

Fournier³

et al. 2016

CJASN

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Background and objectives The predictors of long-term renal function in living kidney donors are currently discussed. Our objectives were to describe the predictors of functional gain of the remaining kidney after kidney donation. We hypothesized that GFR of the remaining kidney divided by volume of this kidney (rk-GFR/vol) would reflect the density of functional nephrons and be inversely associated with functional gain of the remaining kidney.Design, setting, participants, & measurements We conducted a prospective monocentric study including 63 living donors (26 men; 50.3611.8 years old) who had been evaluated for 51 Cr-EDTA and measured GFR, split renal function by scintigraphy before donation (between 2004 and 2009), and measured GFR at 5.760.5 years after donation. For 52 donors, volume of the remaining kidney (measured and estimated with the ellipsoid formula using renal computed tomography scannography) was determined before donation. We tested our hypothesis in an external validation cohort of 39 living donors (13 men; 51.069.4 years old) from another single center during the same time period.Results For the main cohort, the mean measured GFR was 97. Conclusions For given age and body mass index, the long-term functional gain of the remaining kidney is inversely associated with the new variable rk-GFR/vol at donation.

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Section: Discussionmentioning

confidence: 99%

Association of mGFR of the Remaining Kidney Divided by Its Volume before Donation with Functional Gain in mGFR among Living Kidney Donors

Courbebaisse¹,

Tissier²,

Fournier³

et al. 2016

CJASN

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“…21 Many studies demonstrated response of basal GFR to different stimuli from usual chicken and beef meat intake to amino acid and some drugs infusions in healthy individuals. 8,9,[22][23][24][25][26] In our study we first used …”

Section: Discussionmentioning

confidence: 99%

“…4,5 Previous studies have demonstrated increase of glomerular filtration rate (GFR) in response to acute protein load in animals, healthy subjects, and patients with renal disease. [6][7][8][9] It is the renal analog of cardiologic stress test, and used for measurement of renal functional reserve (RFR). 10 RFR is the ability of the kidneys to increase renal plasma flow and GFR in response to protein intake.…”

Section: Introductionmentioning

confidence: 99%

Renal functional reserve and renal hemodynamics in hypertensive patients

et al. 2016

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The renal functional reserve (RFR) is the ability of the kidneys to increase renal plasma flow and glomerular filtration rate (GFR) in response to protein intake. It is a measure of functional and anatomic integrity of nephrons. It is not known what relation between RFR and kidney Doppler parameters. We aimed to study the relation between the RFR and renal hemodynamic parameters in hypertensive patients with and without nephropathy who had normal kidney function. Twenty-four hypertensive subjects with nephropathy (HTN-n, n ¼ 10) and hypertension without nephropathy (HTN, n ¼ 14) were included in the study. Control group included 11 healthy subjects. Baseline GFR (GFR1) and GFR after intake of egg protein 1 mg/kg of body weight were determined (GFR2). RFR was calculated by the following formula: (GFR2-GFR1)/GFR1 Â 100%. Doppler ultrasonography was performed. Arterial blood pressure (BP), body mass index (BMI), and estimated GFR were also recorded. HTN and HTN-n groups had impaired levels of RFR compared with controls (p < 0.05), significantly decreased value of flow velocity parameters (Vmax, Vmin), and increased RRI compared with controls. There was significant negative correlation of RFR with blood pressure levels (sBP, r ¼ À0.435, p ¼ 0.009; dBP, r ¼ À0.504, p ¼ 0.002), RRI (r ¼ À0.456, p ¼ 0.008), micro albuminuria (MAU, r ¼ À0.366, p ¼ 0.031) and positive correlation with Vmax and Vmin (r ¼ 0.556, p ¼ 0.001 and r ¼ 0.643, respectively, p < 0.001). Linear regression showed that RRI and MAU were independent predictors of decreased RFR. RFR is lower in hypertensive patients despite near-normal level of kidney function and is related to particular level of BP. RRI and MAU were independent predictors of decreased RFR. ARTICLE HISTORY

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“…Therefore, the present data should be compared with those of Hostetter [l], Herrera et al [2], Krishna et al [3] and Vanrenterghem et al [4], However, there are also differen ces in the quality and quantity of the protein load. In fact, Vanrenterghem et al [4] utilized a milk derivative which may differently affect hemodynamic response [29,30]. Con cerning the inhibitor of prostaglandin synthesis (table I), Hostetter [I] used no inhibitors, Herrera [2] and Ruilope [6] used oral indomethacin and intravenous ASA was used in the present study.…”

Section: Discussionmentioning

confidence: 99%

Renal Synthesis of Prostaglandins and Thromboxane Has No Causative Role for Protein-Induced Glomerular Hyperfiltration in Healthy Humans

DeSanto

Calò²,

Anastasio³

et al. 1994

Nephron

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The study was devised to establish the role of prostaglandin E₂, prostaglandin_1α and thromboxane A₂ in the genesis of glomerular hyperfiltration response to a meat meal in healthy humans. To this end, a group of 8 healthy women was studied 4 times: in the control state (study 1), after a meat meal (study 2), following a meat meal associated with intravenous aspirin (study 3) and finally after a meat meal associated with intravenous aspirin following 2-day pretreatment with oral aspirin (study 4). Urinary excretion of prostaglandins and thromboxane increased during the glomerular hyperfiltration response to a meat meal and was suppressed by aspirin administration which did not suppress the renal hemodynamic response to the meat meal. The data do not support a causal role for prostaglandins and thromboxane A₂ in the hemodynamic response to acute protein loading.

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Four Ways to Recruit Renal Functional Reserve

Cited by 19 publications

References 0 publications

Association of mGFR of the Remaining Kidney Divided by Its Volume before Donation with Functional Gain in mGFR among Living Kidney Donors

Association of mGFR of the Remaining Kidney Divided by Its Volume before Donation with Functional Gain in mGFR among Living Kidney Donors

Renal functional reserve and renal hemodynamics in hypertensive patients

Renal Synthesis of Prostaglandins and Thromboxane Has No Causative Role for Protein-Induced Glomerular Hyperfiltration in Healthy Humans

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