On the Natural Tendency to Progressive Loss of Remaining Kidney Function in Patients with Impaired Renal Function

Hebert, Lee A.; Bay, William H.

doi:10.1016/s0025-7125(16)30533-8

Cited by 7 publications

(1 citation statement)

References 52 publications

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“…The study of the progression of renal disease has experienced a great development over the last 25 years and the technological advances have made it possible to propose and test several hypotheses [1, 2]. It is now widely accepted that glomerulosclerosis is an intricate process in which numerous factors interrelate but the importance of each factor in this succession of events has not been determined.…”

Section: Introductionmentioning

confidence: 99%

Effects of Ionizing Radiation on Progressive Experimental Renal Disease: A Hemodynamic Approach

Teixeira¹,

Segreto²,

Boim³

et al. 2001

Nephron

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In order to evaluate the progression of renal disease, Munich-Wistar rats were submitted to 5/6 nephrectomy and given whole-body x- or γ-irradiation with or without remnant kidney protection or were submitted only to remnant kidney irradiation. All groups received a single 6-Gy dose immediately after surgery. Whole-kidney function, glomerular hemodynamics, 24-hour proteinuria and histopathology were assessed 60 days after surgery and irradiation. The irradiated nephrectomized animals presented whole-kidney function parameters comparable to those of normal rats. In addition, they were less hypertensive and had higher hematocrit. They showed glomerular hyperfiltration and hypertension even greater than their respective nephrectomized controls. However, the interrelations among the glomerular filtration determinants were somewhat different in irradiated animals. Their 24-hour proteinuria was significantly lower and the sclerosis index and tubulointerstitial injury score were markedly smaller. Among irradiated animals, the worst sclerosis index was observed in those with a shielded remnant kidney and the best in those without protection of the remnant kidney. This led us to speculate about a possible influence of resident mesangial cells on the early events following renal mass ablation and on the maintenance of subsequent physiopathologic changes. Therefore, radiation undoubtedly provoked a beneficial change in the course of renal disease when the renal mass ablation model was employed. Many factors could have contributed to this favorable feature including lower levels of systemic arterial pressure, less increment in ΔP, diminished proteinuria, and maintenance of tubulointerstitial space integrity. Our data also suggest that development of glomerulosclerosis seems to be determined by events occurring immediately after injury.

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Section: Introductionmentioning

confidence: 99%