Nephrol Dial Transplant (1994) 9: 1383-1389
© 1994 European Renal Association-European Dialysis and Transplant Association
research-article
Renal functional reserve in experimental chronic glomerulonephritis
Division of Nephrology-Hypertension, University of California, San Diego School of Medicine, VAMC, La Jolla CA; Parke Davis, Ann Arbor MI; Department of Immunology, Research Institute of Scripps Clinic La Jolla CA USA
Correspondence and offprint requests to: Correspondence and offprint requests to: Luca De Nicola MD, PhD, Dept of Nephrology, University of Naples Medical School via Belvedere 52, 80127 Naples, Italy
Loss of renal functional reserve, that is, absence of the glomerular vasodilatory response to amino-acid infusion, has been interpreted as equivalent to glomerular hyperperfusion/hypertension, and there fore proposed as a marker of high risk for progressive glomerular sclerosis. To substantiate the validity of this hypothesis we evaluated the renal response to glycine and the extent of glomerular damage 10–12 weeks after induction of anti-glomerular basement membrane glomerulonephritis with or without superimposed clip hypertension. Untreated rats and rats chronically treated with quinapril, a converting-enzyme inhibitor, were studied. In untreated groups, loss of renal functional reserve was demonstrated since GFR, single-nephron GFR (SNGFR) and plasma flow (SNPF) did not increase during glycine infusion. The absence of renal reserve was associated with glomerular hyperfusion/hypertension, and development of proteinuria and glomerulosclerosis. Quinapril reduced proteinuria and diffuse sclerosis in anti-glomerular basement membrane GN, and decreased blood pressure and segmental glomeruloscierosis in anti glomerular basement membrane GN with superimposed clip hypertension. Both treated groups demonstrated a restoration of renal functional reserve, as depicted by increases in GFR, SNGFR, and SNPF after glycine, despite persistence of glomerular hyperperfusion/hypertension. These data demonstr that renal functional reserve testing, although it does not detect glomerular hyperperfusion/hypertension, can provide information on the progression of glomerular damage.
Keywords: glomerular hemodynamics; glycine; hypertension; quinapril; rat; tubular reabsorption
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