Renal reserve is normal in patients with dilative cardiomyopathy waiting for heart transplantation.
Renal reserve was explored by means of an oral protein load (2 g/kg body weight) under the form of cooked red meat in a group of 9 patients with end-stage heart failure (ESHF), class III of the New York Heart Association receiving loop diuretics and angiotensin-converting enzyme (ACE) inhibitors, and in a group of 18 healthy controls (HC) matched for age, gender, and height under an identical dietary regimen providing 40 cal/kg per day, 1 g/kg body weight of protein per day, Na 120 mmol/day, and K 50 mmol/day. Baseline glomerular filtration rate averaged 109.5+/-9.89 ml/min x 1.73 m2 in HC and 71.9+/-8.8 ml/min x 1.73 m2 in ESHF. Renal plasma flow averaged 540+/-27 ml/min x 1.73 m2 in HC and 235+/-47 ml/min x 1.73 m2 in ESHF. The filtration fraction was significantly higher in ESHF (p<0.01). Renal reserve averaged 26.03+/-3.28 ml/min x 1.73 m2 in HC and 27.2+/-7.12 ml/min x 1.73 m2 (not significant). Renal reserve averaged 123.9+/-2.9% in HC and 137.3+/-6.68% in ESHF (not significant). The filtration capacity was significantly higher in HC (p<0.001). The data point to a normalcy of renal reserve in ESHF which may depend on the chronic use of ACE inhibitors.
Frangiosa
A
A
Chairs of Nephrology and Heart Surgery, Second University of Naples, Italy.
Spitali
L
L
Molino
D
D
Cirillo
E
E
De Santo
L S
LS
Marra
C
C
Maiello
C
C
De Vivo
F
F
Pascale
C
C
Favazzi
P
P
Di Leo
V A
VA
De Santo
N G
NG
Anastasio
P
P
D000328:Adult; D002311:Cardiomyopathy, Dilated / Q000503:physiopathology* / Q000601:surgery; D005919:Glomerular Filtration Rate / Q000502:physiology; D016027:Heart Transplantation; D006801:Humans; D007668:Kidney / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D012016:Reference Values; D012079:Renal Circulation / Q000502:physiology; D014850:Waiting Lists