title: Renal functional reserve in patients with a reduced number of functioning glomeruli.
abstract: Renal functional reserve (RFR) has been reported to be either reduced or absent in patients with renal insufficiency. Our study consisted in measuring RFR by acute protein load (PL) in 3 groups of patients: the first one was composed of 20 patients (pts) with biopsy-proven glomerular disease (GN) and a varying percentage of sclerotic glomeruli (15-70%); the second one consisted of 10 patients with acquired single kidney (SK) and the third group contained 5 patients with surgical ablation of more than 50% renal tissue (LRRM). Twenty-four healthy volunteers were studied as control subjects. The GFR percentage increase (delta GFR%) after PL in CS did not differ from that of the three groups of patients, despite a significant difference in resting GFR (CS = 113 +/- 11 ml/min/1.73 m2: GN 72 +/- 28 ml/min/1.7, p less than 0.01 vs CS; SK 81 +/- 20 ml/min/1.73 m2, p less than 0.01 vs CS; LRRM 45 +/- 10 ml/min/1.7, p less than 0.01 vs CS; Moreover, an inverse correlation was not found either between GFR and the percentage of sclerotic glomeruli in GN (r = 0.01, p = NS) or between GFR and the extent of excised renal tissue in the other two groups (r = 0.38, p = NS). In conclusion, our data do not confirm that RFR is necessarily reduced or absent in patients with a reduced number of functioning glomeruli, nor do they uphold the hypothesis of constant hyperfiltration in the remaining glomeruli.
authors.affiliation: Division of Nephrology and Dialysis, Policlinico S. Orsola-Malpighi, U.S.L. 28 Bologna Nord, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Zuccalà
authors.forename: R
authors.initials: R
authors.lastname: Gaggi
authors.forename: A
authors.initials: A
authors.lastname: Zucchelli
authors.forename: P
authors.initials: P
authors.lastname: Zucchelli
mesh_terms: D000293:Adolescent; D000328:Adult; D003404:Creatinine / Q000032:analysis; D004044:Dietary Proteins / Q000008:administration & dosage; D005260:Female; D005919:Glomerular Filtration Rate; D005921:Glomerulonephritis / Q000378:metabolism / Q000503:physiopathology*; D005923:Glomerulosclerosis, Focal Segmental / Q000378:metabolism / Q000503:physiopathology*; D006801:Humans; D007444:Inulin / Q000032:analysis; D007678:Kidney Glomerulus / Q000473:pathology / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy; D013997:Time Factors
chemical_list: D004044:Dietary Proteins; D007444:Inulin; D003404:Creatinine