Nephrectomy Modifies Renal Angiotensin II Effects in Kidney Donors

Abstract

In normotensive donors with a normal compensatory response to nephrectomy, baseline renal reactivity to angiotensin II can influence renal and glomerular hemodynamics 1 year after nephrectomy.

Time-Zero Renal Biopsy in Living Kidney Transplantation: A Valuable Opportunity to Correlate Predonation Clinical Data With Histological Abnormalities

“…For kidney donors, donation does not seem to negatively impact long-term outcome in appropriately selected subjects (4). Renal function is partially balanced by the remaining kidney through compensatory changes after unilateral nephrectomy, namely, mild enlargement of the kidney, an approximate 60% increase in glomerular filtration rate (GFR), near 20% increase in the filtration fraction, and 40% increase in effective renal plasma flow (5). The mean GFR has been found to be in the order of 70% to 75% of the prenephrectomy values (6).…”

Maternal and Fetal Outcomes After Living Kidney Donation

“…In addition, human studies report higher rates of HDP in women with preexisting kidney disease (4). After donor nephrectomy, the GFR of the remaining kidney increases by 40%, and its response to hormones such as angiotensin II is altered (7). On (9,10) and maternal death is less than 0.1% (11).…”

Pressor and renal angiotensin II responses before and after nephrectomy

“…4 One kidney ERPF decrease after Ang II was enhanced by nephrectomy in absolute, but not relative terms, whereas glomerular filtration rate, not modified by Ang II before nephrectomy, decreased both in absolute and relative values after nephrectomy, with a consequent filtration fraction decrease. Table 1 shows the data of our 26 donors before and after nephrectomy.…”

“…3 In an earlier study on kidney donors we found that nephrectomy shifts the action of Ang II from the afferent towards the efferent arteriole, 4 increasing efferent resistance and filtration pressure. Although this study revealed a shift in the site of action of Ang II, it did not analyze possible changes in sensitivity to this hormone after loss of renal tissue.…”

“…For the technical details of the experiment the reader is referred to our earlier work. 4 Mean arterial pressure was calculated as (2*diastolic BP þ systolic BP)/3, and renal blood flow as ERPF/1-Hematocrit. Renal vascular resistance before and after the Ang II infusion were calculated by dividing mean arterial pressure by renal blood flow, and the increase in renal resistance after Ang II (DRVR Ang II) was used as the index of renal reactivity, this increase was then multiplied by 100 to obtain the pressure increase required to maintain the same 100 ml min…”