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Renal plasma flow and glomerular filtration rate during acute kidney injury in man

John R Prowle1, Ken Ishikawa, Clive N May

  • 1Department of Intensive Care, Austin Hospital, Heidelberg, Victoria, Australia.

Renal Failure
|April 8, 2010
PubMed

Insights

In acute kidney injury (AKI), reduced renal plasma flow (RPF) is thought to lower glomerular filtration rate (GFR). This systematic review found limited association between RPF and GFR in AKI patients.

Area of Science:

  • Nephrology
  • Renal Physiology

Background:

  • Acute kidney injury (AKI) is characterized by a decline in kidney function.
  • Reduced glomerular filtration rate (GFR) is a hallmark of AKI.
  • The relationship between renal plasma flow (RPF) and GFR in AKI is not fully understood.

Purpose of the Study:

  • To systematically evaluate the evidence linking renal plasma flow (RPF) and glomerular filtration rate (GFR) in human acute kidney injury (AKI).

Main Methods:

  • A systematic search of the PubMed database was conducted for studies measuring RPF and GFR in human AKI.
  • Included studies were analyzed for associations between different measures of RPF (effective RPF and true RPF) and GFR.
  • Data from 22 articles encompassing 250 patients were synthesized.

Main Results:

  • No significant association was found between overall RPF and GFR across studies.
  • Individual patient data showed a limited association between effective renal plasma flow (ERPF) and GFR (r²=0.52).
  • No significant association was detected between true renal plasma flow (TRPF) and GFR in individual patients.

Conclusions:

  • The widely held belief that reduced RPF directly causes lowered GFR in AKI is not strongly supported by current evidence.
  • A limited association exists between ERPF and GFR, but TRPF shows no detectable association with GFR during AKI.
  • Further research is needed to clarify the complex pathophysiology of GFR reduction in AKI.

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