Related Experiment Video
Updated: Oct 13, 2025
06:51
Multilevel Microdissection and Functional-Structural Profiling of Human Renal Arterial Branches
Published on: September 5, 2025
154
Functional Reserve of the Kidney
Armando Armenta1, Magdalena Madero1, Bernardo Rodriguez-Iturbe1,2
1Department of Nephrology, National Institute of Cardiology "Ignacio Chavez," Mexico City, Mexico.
Clinical Journal of the American Society of Nephrology : CJASN
|November 11, 2021
Summary
Assessing kidney functional reserve using stress tests reveals adaptive capacity loss before baseline impairment. This helps evaluate chronic kidney disease (CKD) prognosis and progression, identifying subclinical injury.
Area of Science:
- Nephrology
- Physiology
- Renal Medicine
Background:
- Kidney injury often impairs adaptive physiological responses, but these changes are rarely assessed before baseline function declines.
- Functional reserve, representing adaptive reactivity, is crucial for evaluating prognosis and disease progression in kidney conditions.
Purpose of the Study:
- To explore normal physiological response limits and their loss during kidney injury.
- To discuss the diagnostic utility of kidney stress tests in identifying subclinical renal injury and assessing functional reserve.
Main Methods:
- Review of stress tests evaluating protein-induced hyperfiltration.
- Examination of tests for proximal tubular secretion, urea-selective concentration defects, and acid retention.
- Discussion of diseases where these tests aid in diagnosing subclinical kidney injury.
Main Results:
- Differences between resting and stressed physiological responses indicate adaptive reactivity that diminishes before baseline function is impaired.
- Kidney stress tests can identify subclinical injury by detecting abnormalities in functional reserve.
Conclusions:
- Abnormal functional reserve, identified through stress testing, is an important indicator for evaluating prognosis and progression in chronic kidney disease (CKD).
- Further study and follow-up of abnormal functional reserve can significantly enhance understanding of the natural history of CKD.
Keywords:
kidney disease
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