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Tubular compensation for glomerular filtration rate decrease in chronic renal failure - the clinicopharmacologic
International Journal of Clinical Pharmacology, Therapy, and Toxicology
|August 1, 1981
Summary
This study introduces a new method to assess kidney tubular function compensation using fractional excretion (FE) of sodium, water, and potassium. This helps manage chronic kidney disease (CKD) by guiding diuretic and dietary therapies.
Area of Science:
- Nephrology
- Renal Physiology
- Internal Medicine
Background:
- Decreased Glomerular Filtration Rate (GFR) can be compensated by tubular functions of remaining nephrons to maintain internal milieu homeostasis.
- Assessing the adequacy of tubular compensation is crucial for managing patients with declining kidney function.
Purpose of the Study:
- To present a novel method for estimating the adequacy of tubular compensation.
- To utilize fractional excretion (FE) of sodium, water, and potassium for this estimation.
- To provide a formula for calculating adequate FE values based on GFR and intake.
Main Methods:
- Investigation of fractional excretion (FE) of sodium, water, and potassium.
- Calculation of adequate FE using the formula: FE = 1.15 I/GFR . S, assuming minimal extrarenal excretion.
- Analysis of FE parameters in patients with GFR < 0.17 ml/s.
Main Results:
- In patients with GFR < 0.17 ml/s, fractional excretion of sodium (FENa) was 20-25%.
- Fractional excretion of water (FEH2O) ranged from 30-35%.
- Fractional excretion of potassium (FEK) reached 150-200%.
Conclusions:
- The developed method effectively estimates tubular compensation adequacy in reduced GFR.
- FE measurements (FENa, FEH2O, FEK) provide valuable insights into renal function.
- These estimations aid in guiding and monitoring diuretic and dietary restriction therapies for kidney disease patients.