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Related Experiment Videos

Renal functional reserve in pregnancy.

C Ronco1, A Brendolan, L Bragantini

  • 1Department of Nephrology, St Bortolo Hospital, Vicenza, Italy.

Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association
|January 1, 1988
PubMed
Summary

Creatinine clearance, a reliable marker for glomerular filtration rate (GFR), increases significantly after a protein load in both normal and pregnant women. This indicates GFR reflects functioning renal mass.

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Area of Science:

  • Nephrology
  • Physiology
  • Obstetrics

Background:

  • Glomerular filtration rate (GFR) assessment is crucial in pregnancy.
  • Creatinine clearance is a common method for estimating GFR.
  • Pregnancy-induced physiological changes may affect renal function.

Purpose of the Study:

  • To evaluate creatinine clearance under baseline and post-protein load conditions in pregnant and non-pregnant women.
  • To determine if creatinine is a reliable marker for GFR during pregnancy.
  • To assess the impact of protein load on GFR in different stages of pregnancy.

Main Methods:

  • Measured creatinine clearance hourly at baseline (resting GFR) and for 4 hours after an 80g protein meal (test GFR) in 5 normal and 29 pregnant women.
  • Compared creatinine clearance with inulin clearance in seven subjects post-protein load.

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  • Analyzed GFR variations based on pregnancy stage and protein intake.

    • Main Results:

    • Resting GFR increased progressively during pregnancy, from 99.8 ml/min/1.73m² in the first month to 149.6 ml/min/1.73m² in the last month.
    • All subjects showed a significant GFR increase after protein load, with the largest difference in the first trimester.
    • Creatinine and inulin clearance values did not differ significantly, validating creatinine as a GFR marker.
    • Test GFR averaged 163.3 ml/min/1.73m² in normal subjects and 163.8 ml/min/1.73m² in pregnant women, irrespective of gestational stage.

    Conclusions:

    • Creatinine clearance is a reliable marker for estimating GFR in pregnant and non-pregnant women.
    • Acute protein load significantly increases GFR, suggesting it reflects the kidney's filtration capacity.
    • The stable test GFR in pregnant women suggests it represents the functioning renal mass.