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Renal Reserve

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By Isabel Acosta-Ochoa Nephrology senior staff. Valladolid. Spain
https://www.readbyqxmd.com/read/30089036/renal-functional-reserve-capacity-before-and-after-living-kidney-donation
#1
Marco van Londen, Nicolien Kasper, Niek R Hessels, A Lianne Messchendorp, Stephan J L Bakker, Jan-Stephan F Sanders, Stefan P Berger, Martin H de Borst, Gerjan Navis
Compensatory GFR increase after kidney donation results in a GFR above 50% of the pre-donation value. The Renal Functional Reserve assessed by the renal response to dopamine infusion (RFRdopa ) is considered to reflect functional reserve capacity and thought to be a tool for living donor screening. However, it is unknown if the RFRdopa predicts long-term kidney function. Between 1984 and 2017, we prospectively measured mGFR (125- I-Iothalamate) and RFR by dopamine infusion in 937 living kidney donors. We performed linear regression analysis of pre-donation RFRdopa and post-donation GFR...
August 8, 2018: American Journal of Physiology. Renal Physiology
https://www.readbyqxmd.com/read/30053231/persistent-decrease-of-renal-functional-reserve-in-patients-after-cardiac-surgery-associated-acute-kidney-injury-despite-clinical-recovery
#2
Faeq Husain-Syed, Fiorenza Ferrari, Aashish Sharma, Tommaso Hinna Danesi, Pércia Bezerra, Salvador Lopez-Giacoman, Sara Samoni, Massimo de Cal, Valentina Corradi, Grazia Maria Virzì, Silvia De Rosa, María Jimena Muciño Bermejo, Carla Estremadoyro, Gianluca Villa, Jose J Zaragoza, Carlotta Caprara, Alessandra Brocca, Horst-Walter Birk, Hans-Dieter Walmrath, Werner Seeger, Federico Nalesso, Monica Zanella, Alessandra Brendolan, Davide Giavarina, Loris Salvador, Rinaldo Bellomo, Mitchell H Rosner, John A Kellum, Claudio Ronco
Background: Cardiac surgery is a leading cause of acute kidney injury (AKI). Such AKI patients may develop progressive chronic kidney disease (CKD). Others, who appear to have sustained no permanent loss of function (normal serum creatinine), may still lose renal functional reserve (RFR). Methods: We extended the follow-up in the observational 'Preoperative RFR Predicts Risk of AKI after Cardiac Surgery' study from hospital discharge to 3 months after surgery for 86 (78...
July 19, 2018: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/22866976/acute-kidney-injury-and-residual-renal-function
#3
COMMENT
Claudio Ronco, Mitchell H Rosner
Acute kidney injury (AKI) occurring in patients admitted to the ICU may result in impaired renal function on long-term follow-up after ICU discharge. The damage induced by subclinical or manifest episodes of AKI may, in fact, produce an irreversible loss of a variable amount of renal mass with deleterious effects on overall renal function. This may be the case even though baseline glomerular filtration rate appears to return to normal but renal reserve is impaired. This may have an important effect on long-term outcomes, including progression to chronic kidney disease...
August 3, 2012: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29892792/the-renal-blood-flow-reserve-in-healthy-humans-and-patients-with-atherosclerotic-renovascular-disease-measured-by-positron-emission-tomography-using-15-o-h-2-o
#4
Johanna Päivärinta, Niina Koivuviita, Vesa Oikonen, Hidehiro Iida, Kaisa Liukko, Ilkka Manner, Eliisa Löyttyniemi, Pirjo Nuutila, Kaj Metsärinne
BACKGROUND: Microvascular function plays an important role in ARVD (atherosclerotic renovascular disease). RFR (renal flow reserve), the capacity of renal vasculature to dilate, is known to reflect renal microvascular function. In this pilot study, we assessed PET (positron emission tomography)-based RFR values of healthy persons and renal artery stenosis patients. Seventeen patients with ARVD and eight healthy subjects were included in the study. Intravenous enalapril 1 mg was used as a vasodilatant, and the maximum response (blood pressure and RFR) to it was measured at 40 min...
June 11, 2018: EJNMMI Research
https://www.readbyqxmd.com/read/29793670/renal-functional-reserve-revisited
#5
REVIEW
Ragnar Palsson, Sushrut S Waikar
Kidney function, like the function of other organs, is dynamic and continuously adjusts to changes in the internal environment to maintain homeostasis. The glomerular filtration rate, which serves as the primary index of kidney function in clinical practice, increases in response to various physiological and pathological stressors including oral protein intake. The difference between the glomerular filtration rate in the resting state and at maximum capacity has been termed renal functional reserve (RFR). RFR could provide additional information on kidney health and renal function prognosis...
May 2018: Advances in Chronic Kidney Disease
https://www.readbyqxmd.com/read/29382510/preoperative-renal-functional-reserve-predicts-risk-of-acute-kidney-injury-after-cardiac-operation
#6
Faeq Husain-Syed, Fiorenza Ferrari, Aashish Sharma, Tommaso Hinna Danesi, Pércia Bezerra, Salvador Lopez-Giacoman, Sara Samoni, Massimo de Cal, Valentina Corradi, Grazia Maria Virzì, Silvia De Rosa, María Jimena Muciño Bermejo, Carla Estremadoyro, Gianluca Villa, Jose J Zaragoza, Carlotta Caprara, Alessandra Brocca, Horst-Walter Birk, Hans-Dieter Walmrath, Werner Seeger, Federico Nalesso, Monica Zanella, Alessandra Brendolan, Davide Giavarina, Loris Salvador, Rinaldo Bellomo, Mitchell H Rosner, John A Kellum, Claudio Ronco
BACKGROUND: Although acute kidney injury (AKI) frequently complicates cardiac operations, methods to determine AKI risk in patients without underlying kidney disease are lacking. Renal functional reserve (RFR) can be used to measure the capacity of the kidney to increase glomerular filtration rate under conditions of physiologic stress and may serve as a functional marker that assesses susceptibility to injury. We sought to determine whether preoperative RFR predicts postoperative AKI...
April 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29384274/-understanding-renal-functional-reserve
#7
Clara Hoffmann, Stéphanie Zbinden, Vincent Bourquin
Renal function is usually estimated through the blood measurement of creatinine, which allows estimating the glomerular filtration rate (GFR). However, this value only decreases when half the nephrons are damaged, limiting the detection of early renal disease. The ingestion of an important amount of protein can increase the GFR. The renal functional reserve concept is the difference between the maximal GFR, stimulated by an important protein intake, and the baseline GFR. A diminished renal functional reserve could mean glomerular hyperfiltration and early renal disease...
January 31, 2018: Revue Médicale Suisse
https://www.readbyqxmd.com/read/29357424/overweight-young-female-kidney-donors-have-low-renal-functional-reserve-postdonation
#8
Marco van Londen, Anouk W M A Schaeffers, Martin H de Borst, Jaap A Joles, Gerjan Navis, A Titia Lely
Maintenance of adequate renal function after living kidney donation is important for donor outcome. Overweight donors, in particular, may have an increased risk for end-stage kidney disease (ESKD), and young female donors have an increased preeclampsia risk. Both of these risks may be associated with low postdonation renal functional reserve (RFR). Because we previously found that higher body mass index (BMI) was associated with lower postdonation RFR, we now studied the relationship between BMI and RFR in young female donors...
September 1, 2018: American Journal of Physiology. Renal Physiology
https://www.readbyqxmd.com/read/29327197/-new-kidney-function-tests-renal-functional-reserve-and-furosemide-stress-test
#9
REVIEW
D Kindgen-Milles, T Slowinski, T Dimski
Acute kidney injury (AKI) occurs in 30-50% of all intensive care patients. Renal replacement therapy (RRT) has to be initiated in 10-15%. The early in-hospital mortality is about 50%. Up to 20% of all survivors develop chronic kidney disease after intensive care discharge and progress to end-stage kidney disease within the next 10 years. For timely initiation of prophylactic or therapeutic interventions, it is crucial to exactly determine the actual kidney function, i. e., glomerular filtration rate (GFR), and to gain insight into the further development of kidney function...
January 11, 2018: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/29248146/renal-recovery
#10
REVIEW
Ivan Göcze, Christina Wiesner, Hans J Schlitt, Tobias Bergler
Recovery patterns after acute kidney injury (AKI) have increasingly become the focus of research, because currently available preventive measures and specific therapeutic intervention are limited. Moreover, changes in renal functional reserve are recognized as a "hidden" indicator of kidney susceptibility to either acute kidney injury or chronic kidney disease. Understanding these phenomena and their association with outcome may enable the initiation of strategies that facilitate fast and sustained recovery during the time course of AKI and limit AKI progression towards chronic kidney disease...
September 2017: Best Practice & Research. Clinical Anaesthesiology
https://www.readbyqxmd.com/read/29068795/the-role-of-renal-response-to-amino-acid-infusion-and-oral-protein-load-in-normal-kidneys-and-kidney-with-acute-and-chronic-disease
#11
REVIEW
Francis B Gabbai
PURPOSE OF REVIEW: High protein intake and hyperfiltration have been a focus of major interest as potential mechanism(s) of progression of renal disease. This review will examine: the renal response to a protein meal or amino acid infusion and its use to test the renal functional reserve (RFR); new methods to evaluate RFR; the use of RFR in various pathophysiologic conditions. RECENT FINDINGS: The renal response to protein/amino acid infusion involves several mechanisms, including nitric oxide, insulin, glucagon, arginine vasopressin, urea, the renal N-Methyl-D-Aspartate Glutamate receptor and modulation of the activity of the tubuloglomerular feedback system...
January 2018: Current Opinion in Nephrology and Hypertension
https://www.readbyqxmd.com/read/28953557/real-time-measurement-of-glomerular-filtration-rate
#12
REVIEW
Richard Solomon, Stuart Goldstein
PURPOSE OF REVIEW: Measurement of glomerular filtration rate is an essential tool for determining the health or dysfunction of the kidney. The glomerular filtration rate is a dynamic function that can change almost instantaneously in response to stressors. Despite its central role in nephrology, there are no techniques available to the clinician for monitoring glomerular filtration rate in real time. Recent advances in technology to measure fluorescent compounds through the skin are providing a new approach for real-time monitoring of glomerular filtration rate...
December 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/28807269/renal-functional-reserve-and-pregnancy-outcomes
#13
LETTER
Abhilash Koratala, Amir Kazory
No abstract text is available yet for this article.
September 2017: Kidney International
https://www.readbyqxmd.com/read/28329736/delay-in-renal-hemodynamic-response-to-a-meat-meal-in-severe-obesity
#14
Pietro Anastasio, Davide Viggiano, Miriam Zacchia, Claudia Altobelli, Giovambattista Capasso, Natale Gaspare De Santo
BACKGROUND/AIMS: Little information is available about the tubular functions and the renal adjustments that take place in obese subjects after a protein meal. How the excess fat may affect renal response to dietary proteins is currently only partially understood. This paper aims to address (i) whether severe obesity, in the absence of other comorbidities, is responsible of kidney dysfunction at either the glomerular or the tubular level and (ii) whether it compromises renal adaptations to a large protein meal...
2017: Nephron
https://www.readbyqxmd.com/read/28223001/rethinking-ckd-evaluation-should-we-be-quantifying-basal-or-stimulated-gfr-to-maximize-precision-and-sensitivity
#15
REVIEW
Bruce A Molitoris
Chronic kidney disease (CKD) is an increasing clinical problem. Although clinical risk factors and biomarkers for the development and progression of CKD have been identified, there is no commercial surveillance technology to definitively diagnose and quantify the severity and progressive loss of glomerular filtration rate (GFR) in CKD. This has limited the study of potential therapies to late stages of CKD when FDA-registerable events are more likely. Because patient outcomes, including the rate of CKD progression, correlate with disease severity and effective therapy may require early intervention, being able to diagnose and stratify patients by their level of decreased kidney function early on is key for translational progress...
May 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/28052302/rationale-for-the-evaluation-of-renal-functional-reserve-in-living-kidney-donors-and-recipients-a-pilot-study
#16
Alessandra Spinelli, Aashish Sharma, Gianluca Villa, Sara Samoni, Francesco Ramponi, Alessandra Brocca, Alessandra Brendolan, Stefano Chiaramonte, Giuseppe Castellano, Loreto Gesualdo, Claudio Ronco
BACKGROUND: In living kidney transplantation, preoperative donors' renal functional reserve (RFR) may correlate with postoperative residual renal function in both donors and recipients. The aim of this study was to evaluate the donors' RFR before transplantation and to compare basal and stress renal function before and after transplantation in both donors and recipients. METHODS: Seven pairs of living kidney donors and recipients were considered for this observational study...
2017: Nephron
https://www.readbyqxmd.com/read/27898524/uromodulin-in-kidney-health-and-disease
#17
REVIEW
Pranav S Garimella, Mark J Sarnak
PURPOSE OF REVIEW: Although uromodulin or Tamm-Horsfall protein was discovered over 60 years ago, its functional role in humans remains unclear. This review highlights new studies elucidating the clinical correlates of uromodulin, its association with kidney function decline, nephrolithiasis and urinary host defense. RECENT FINDINGS: Uromodulin is evolutionarily conserved and has multiple functional roles. In large population studies, higher levels of uromodulin are associated with higher estimated glomerular filtration rate (eGFR) and kidney size, possibly indicating greater kidney functional reserve...
March 2017: Current Opinion in Nephrology and Hypertension
https://www.readbyqxmd.com/read/27820705/use-of-stress-tests-in-evaluating-kidney-disease
#18
REVIEW
Jay L Koyner, Lakhmir S Chawla
PURPOSE OF REVIEW: The kidney, like most other organs, has a reserve capacity that can be utilized in times of increased physiologic demand. The ability to quantify this renal reserve function across various parts of the nephron (glomerular and tubular) has been an area of increased investigation over the past several years. In this review, we discuss several techniques that have been developed to interrogate the maximal physiologic capacity of the injured kidney. RECENT FINDINGS: Although protein loading has been established as an ideal method to investigate glomerular filtration capacity in healthy kidneys, other methods such as the antagonism of the renin-angiotensin-aldosterone system have demonstrated promise as a method to determine underlying glomerular disease in those with acute kidney injury and other comorbidities (e...
January 2017: Current Opinion in Nephrology and Hypertension
https://www.readbyqxmd.com/read/27470640/renal-functional-reserve-and-renal-hemodynamics-in-hypertensive-patients
#19
Abduzhappar Gaipov, Yalcin Solak, Nurlan Zhampeissov, Aliya Dzholdasbekova, Nadezhda Popova, Miklos Z Molnar, Saltanat Tuganbekova, Elmira Iskandirova
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 = 10) and hypertension without nephropathy (HTN, n = 14) were included in the study...
October 2016: Renal Failure
https://www.readbyqxmd.com/read/27458386/intra-parenchymal-renal-resistive-index-variation-irriv-describes-renal-functional-reserve-rfr-pilot-study-in-healthy-volunteers
#20
Sara Samoni, Federico Nalesso, Mario Meola, Gianluca Villa, Massimo De Cal, Silvia De Rosa, Ilaria Petrucci, Alessandra Brendolan, Mitchell H Rosner, Claudio Ronco
An increase of glomerular filtration rate after protein load represents renal functional reserve (RFR) and is due to afferent arteriolar vasodilation. Lack of RFR may be a risk factor for acute kidney injury (AKI), but is cumbersome to measure. We sought to develop a non-invasive, bedside method that would indirectly measure RFR. Mechanical abdominal pressure, through compression of renal vessels, decreases blood flow and activates the auto-regulatory mechanism which can be measured by a fall in renal resistive index (RRI)...
2016: Frontiers in Physiology
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