Lack of Diurnal Variation in Glomerular Filtration Rates in the Elderly

Sunaga, Ken‐ichiro; Sudoh, Toshiaki; Fujimura, Akio

doi:10.1002/j.1552-4604.1996.tb04189.x

Cited by 9 publications

(4 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This view is supported by the low agreement between the estimated and measured 24-hour creatininuria [16]. Circadian variability of GFR with lowered values during night-time may also be significant, although a previous study found this phenomenon somewhat blunted in the elderly when compared with younger subjects [17]. Therefore, the CINU obtained in the morning may not represent mean 24-hour GFR.…”

Section: Discussionmentioning

confidence: 66%

Bedside Estimation of the Glomerular Filtration Rate in Hospitalized Elderly Patients

Burkhardt¹,

Hahn²,

Gretz

et al. 2005

Nephron Clin Pract

View full text Add to dashboard Cite

Aims: To evaluate the quality of bedside estimation of glomerular filtration rate (GFR) in hospitalized elderly patients. Methods: We evaluated common estimators of GFR in 29 women and 32 men aged 60 and older hospitalized in a geriatric ward: creatinine clearance (CCR), the Cockcroft-Gault formula (CG), the modification of diet in renal disease formula (MDRD), Baracskay formula (BAR), and a newly developed formula derived recently by us (GCM). Inulin clearance (CINU) was used to assess GFR. Exclusion criteria were mental illness and urinary incontinence. Results: According to Bland and Altman accuracy and precision of all estimators were low and there was an underestimation of actual GFR: CCR 38.9 ml/min; CG 39.7 ml/min; MDRD 19.8 ml/min; BAR 34.0 ml/min, and GCM: 24.7 ml/min. The accuracy and precision of all methods were even lower in patients with a GFR of >90 ml/min and in patients with diabetes. In receiver-operating characteristics (ROC analysis) all formulas were superior to serum creatinine and overall MDRD disclosed the best results in detecting both a GFR of <90 ml/min and <60 ml/min. Conclusions: In general, estimation errors are large in an acute care setting. However, formula estimation is clearly superior to serum creatinine and CCR. MDRD gave the best results but may be replaced by the more simple CG and GCM formulas, whereas BAR was inferior.

show abstract

Section: Discussionmentioning

confidence: 66%

Bedside Estimation of the Glomerular Filtration Rate in Hospitalized Elderly Patients

Burkhardt¹,

Hahn²,

Gretz

et al. 2005

Nephron Clin Pract

View full text Add to dashboard Cite

show abstract

“…The cellular origin and molecular mechanisms underlying the circadian rhythm of GFR have intrigued physiologists and clinicians for decades. Interest into this field was stimulated by clinical observations that the amplitude of circadian oscillations in GFR is reduced with age 35 and, that the circadian rhythm in GFR is dampened or inverted in patients with the nephrotic syndrome 14 , heart failure 36 or cirrhosis 12 . Early studies demonstrating that the circadian rhythm in GFR is independent on circadian oscillations in BP, cardiac output and sympathetic regulation suggested that an intrarenal self-autonomous mechanism(s) might be involved 14,15 .…”

Section: Discussionmentioning

confidence: 99%

The intrinsic circadian clock in podocytes controls glomerular filtration rate

Ansermet

Centeno

Nikolaeva

et al. 2019

Sci Rep

View full text Add to dashboard Cite

Glomerular filtration rate (GFR), or the rate of primary urine formation, is the key indicator of renal function. Studies have demonstrated that GFR exhibits significant circadian rhythmicity and, that these rhythms are disrupted in a number of pathologies. Here, we tested a hypothesis that the circadian rhythm of GFR is driven by intrinsic glomerular circadian clocks. We used mice lacking the circadian clock protein BMAL1 specifically in podocytes, highly specialized glomerular cells critically involved in the process of glomerular filtration (Bmal1lox/lox/Nphs2-rtTA/LC1 or, cKO mice). Circadian transcriptome profiling performed on isolated glomeruli from control and cKO mice revealed that the circadian clock controls expression of multiple genes encoding proteins essential for normal podocyte function. Direct assessment of glomerular filtration by inulin clearance demonstrated that circadian rhythmicity in GFR was lost in cKO mice that displayed an ultradian rhythm of GFR with 12-h periodicity. The disruption of circadian rhythmicity in GFR was paralleled by significant changes in circadian patterns of urinary creatinine, sodium, potassium and water excretion and by alteration in the diurnal pattern of plasma aldosterone levels. Collectively, these results indicate that the intrinsic circadian clock in podocytes participate in circadian rhythmicity of GFR.

show abstract

“…If this variation of GFR over 24 h seems to be robust in young individuals, it might be blunted in older patients [10] or at least under particular conditions. Indeed, when compared with young hypertensive, older hypertensive subjects had blunted GFR oscillations as measured by creatinine clearance [11].…”

Section: Introductionmentioning

confidence: 95%

Circadian glomerular function: from physiology to molecular and therapeutical aspects

Wuerzner¹,

Firsov²,

Bonny³

2014

Nephrology Dialysis Transplantation

View full text Add to dashboard Cite

Life on earth is rhythmic by essence due to day/night alternation, and many biological processes are also cyclic. The kidney has a special role in the organism, controlling electrolytes and water balance, blood pressure, elimination of metabolic waste and xenobiotics and the production of several hormones. The kidney is submitted to changes throughout 24 h with periods of intense activity followed by calmer periods. Filtration, reabsorption and secretion are the three components determining renal function. Here, we review circadian changes related to glomerular function and proteinuria and emphasize the role of the clock in these processes.

show abstract

Lack of Diurnal Variation in Glomerular Filtration Rates in the Elderly

Cited by 9 publications

References 7 publications

Bedside Estimation of the Glomerular Filtration Rate in Hospitalized Elderly Patients

Bedside Estimation of the Glomerular Filtration Rate in Hospitalized Elderly Patients

The intrinsic circadian clock in podocytes controls glomerular filtration rate

Circadian glomerular function: from physiology to molecular and therapeutical aspects

Contact Info

Product

Resources

About