Author/Editor     Pajek, Jernej; Kaplan-Pavlovčič, Staša
Title     Raziskovalni in klinični pomen merjenja ledvične funkcijske rezerve
Translated title     Experimental and clinical significance of renal functional reserve determination
Type     članek
Source     Zdrav Vestn
Vol. and No.     Letnik 71, št. 7-8
Publication year     2002
Volume     str. 467-70
Language     slo
Abstract     Background. Renal functional reserve (RFR) is defined as the temporary increase in glomerular filtration rate (GFR) which follows the ingestion of proteins or infusion of aminoacids. This renal vasodilatatory response is probably mediated by several mechanisms, whit nitric oxide being one of the most important mediators. In the last years significant progress in measuring renal functional reserve has been achieved on the basis of improvements in methods for accurate and timely appropriate GFR measurement. The method of GFR measurement using the sinistrin clearence calculation after bolus injection of sinistrin is increasingly employed. Conclusions. The article presents the latest results of experiments with RFR using this method and compares them with older reports. RFR is affected by several patophysiological processes: arterial hypertension, diabetes mellitus, deteriorating function of transplanted kidney. The results and impact of RFR determination in this conditions are described. Finally, potential for further research of RFR in atherosclerotic vascular disease is considered. Accurate determination of RFR is important for detection of early renal hemodynamic abnormalities, which can be influenced by therapeutic interventions and in this way the progression of renal functional deterioration could be prevented or at least slowed.
Summary     Izhodišča. Ledvična funkcijska rezerva (LFR) je prehodno zvečanje glomerulne filtracije, ki ga izzovemo s proteinskim obrokom ali infuzijo aminokislin. Je ledvični vazodilatacijski odziv, za katerega je verjetno odgovornih več posrednikov, med najpomembnejše spada dušikov monoksid. Izboljšanje metod za natančno in časovno primerno merjenje hitrosti glomerulne filtracije (GFR) je v zadnjem času omogočilo pomemben napredek pri merjenju LFR. Uveljavlja se metoda merjenja GFR prek izračuna klirensa sinistrina po bolusnem odmerku tega markerja. Zaključki. V članku predstavljava rezultate novejših raziskav LFR s to metodo in jih primerjava s starejšimi raziskavami. Na spremembe LFR vplivajo različna patofiziološka stanja: arterijska hipertenzija, sladkorna bolezen, slabšanje delovanja presajene ledvice. Članek podaja pregled izsledkov in pomena merjenja LFR pri teh stanjih. Na koncu obravnava možnosti za nadaljne raziskave LFR pri aterosklerotični prizadetosti žilja. Točno merjenje LFR je pomembno za ugotavljanje zgodnjih bolezenskih sprememb ledvične hemodinamike, na katere lahko vplivamo z zdravljenjem in tako preprečimo ali vsaj upočasnimo slabšanje ledvične funkcije.
Descriptors     GLOMERULAR FILTRATION RATE
CREATINE
METABOLIC CLEARANCE RATE
INULIN
HYPERTENSION
DIABETES MELLITUS
NEPHRECTOMY
KIDNEY TRANSPLANTATION
ATHEROSCLEROSIS