Document Detail


Dynamic renal function testing by compartmental analysis: assessment of renal functional reserve in essential hypertension.
MedLine Citation:
PMID:  10910439     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: In essential hypertension, acute haemodynamic changes due to dietary protein load cause patterns of acute changes in renal function that are fundamentally different from changes in normal controls.
METHODS: Renal clearances of sinistrin, an inulin-like polyfructosan, and p-aminohippurate were determined before and after protein ingestion. These tests were performed in healthy controls and in patients with essential hypertension (mean arterial pressure of 112+/-2 mmHg, age, 52+/-2 years; mean+/-SEM) within a washout period, and after long-term treatment with carvedilol and fosinopril, respectively.
RESULTS: In 15 healthy volunteers, protein ingestion increased glomerular filtration rate (GFR) from 110.3+/-3.6 to 120. 6+/-4.4 ml/min (P=0.0006; two-tailed pairwise t-test). In contrast, it led to an acute decrease in GFR in 16 hypertensive patients, from 111.8+/-2.9 to 103.6+/-3.3 ml/min (P=0.0010). The eight patients who were randomized to receive carvedilol improved in their renal response to protein (GFR increased from 101.4+/-6.4 to 107.1+/-5.4 ml/min; P=0.04), whereas the eight other patients randomized to receive fosinopril exhibited no change in GFR (final value 105+/-4.9 ml/min). In the patients, the acute shifts in renal plasma flows were not significant. Mean arterial blood pressure of the patients decreased from 112+/-2 to 100+/-3 mmHg (P=0.0015).
CONCLUSIONS: In essential hypertension an acute protein load induces a decrease in GFR that may normalize under antihypertensive treatment. The acute changes in GFR can be reliably monitored by the here-described compartmental analysis method of renal functional reserve.
Authors:
S Zitta; K Stoschitzky; R Zweiker; K Oettl; G Reibnegger; H Holzer; W Estelberger
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association     Volume:  15     ISSN:  0931-0509     ISO Abbreviation:  Nephrol. Dial. Transplant.     Publication Date:  2000 Aug 
Date Detail:
Created Date:  2000-09-08     Completed Date:  2000-09-08     Revised Date:  2013-05-28    
Medline Journal Info:
Nlm Unique ID:  8706402     Medline TA:  Nephrol Dial Transplant     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  1162-9     Citation Subset:  IM    
Affiliation:
Department of Internal Medicine, Division of Nephrology, University of Graz, Austria.
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MeSH Terms
Descriptor/Qualifier:
Adult
Antihypertensive Agents / therapeutic use
Blood Pressure / drug effects
Carbazoles / therapeutic use
Dietary Proteins / pharmacology
Female
Fosinopril / therapeutic use
Glomerular Filtration Rate / drug effects
Humans
Hypertension / drug therapy,  physiopathology*
Kidney / metabolism,  physiopathology*
Kidney Function Tests / methods*
Male
Middle Aged
Oligosaccharides / metabolism
Propanolamines / therapeutic use
Reference Values
Renal Circulation / drug effects
Vascular Resistance / drug effects
p-Aminohippuric Acid / metabolism
Chemical
Reg. No./Substance:
0/Antihypertensive Agents; 0/Carbazoles; 0/Dietary Proteins; 0/Oligosaccharides; 0/Propanolamines; 0K47UL67F2/carvedilol; 37311-25-4/sinistrin; 61-78-9/p-Aminohippuric Acid; 98048-97-6/Fosinopril

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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