The Physiologic Basis for Renal Functional Reserve Testing

  • Francis B. Gabbai
  • Luca De Nicola
  • Roland C. Blantz

Abstract

Early studies by Pitts demonstrated that protein intake (meat meal) or intravenous administration of amino acid (glycine) to dogs were associated with significant increases in glomerular filtration rate (GFR) and renal plasma flow (RPF) (1, 2). Variations in daily protein intake are also capable of modifying GFR and RPF in both man and experimental animals, with increments in GFR and RPF paralleling the increase in quantity of protein (1–3). Although the acute and chronic effects of protein loading on renal function have been established for nearly 50 years, it is not until recently that major interest has accumulated with respect to the potential role of protein in the progression of renal disease. Pioneer work by Hostetter et al (4) demonstrated in a model of radical subtotal nephrectomy in rats that increased protein intake was associated with hyperfiltration secondary to glomerular hypertension and hyperperfusion. Reducing protein intake in this experimental model decreased hyperfiltration and prevented albuminuria and glomerular sclerosis. Further studies in different experimental models, which include streptozotocininduced diabetes mellitus, hypertension and partial renal ablation, confirmed previous findings by Hostetter et al and supported the concept that hyperfiltration may play an important role in the progression of kidney disease (5–7). The presence of hyperfiltration in experimental models led many investigators to evaluate the role of hyperfiltration as a mechanism for progression of renal disease in man. Normal pregnancy, early stages of insulin-dependent diabetes mellitus and sickle cell disease are a few clinical conditions associated with absolute increases in GFR (8–10). Since most patients with renal disease have normal or low values of GFR, it is impossible to detect the presence of hyperfiltration by evaluation of absolute GFR values under normal conditions.

Keywords

Dopamine Glycine Prostaglandin Xylose Cardiol 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Pitts RF: The effect of protein and amino acid metabolism on the urea and xylose clearance. J Nutrition, 9: 645–666, 1935.Google Scholar
  2. 2.
    Pitts RF: The effects of infusing glycine and of varying the dietary protein intake on renal hemodynamics in the dog. Am J Physiol, 142: 355–365, 1944.Google Scholar
  3. 3.
    Pullman TN, Alving AS, Dern RJ, Landowne M: The influence of dietary protein on specific renal functions in normal man. J Lab Clin Med, 44: 320–332, 1954.PubMedGoogle Scholar
  4. 4.
    Hostetter TH, Olson JL, Rennke HG, Venkatachalam MA, Brenner BM: Hyperfiltration in remnant nephrons: A potentially adverse reaction to renal ablation. Am J Physiol, 241: F85–F93, 1981.PubMedGoogle Scholar
  5. 5.
    Anderson S, Meyer TW, Rennke HG, Brenner BM: Control of glomerular hypertension limits glomerular injury in rats with reduced renal mass. J Clin Invest, 76: 612–619, 1985.PubMedGoogle Scholar
  6. 6.
    Dworkin LD, Hostetter TH, Rennke HG, Brenner BM: Hemodynamic basis for glomerular injury in rats with desoxycorticosterone-salt hypertension. J Clin Invest, 73: 1448–1461, 1984.PubMedGoogle Scholar
  7. 7.
    Zatz R, Meyer TW, Rennke HG, Brenner BM: Predominance of hemodynamic rather than metabolic factors in the pathogenesis of diabetic glomerulopathy. Proc Natl Acad Sci USA, 82: 5963–5967, 1985.PubMedGoogle Scholar
  8. 8.
    Lindheimer MD, Katz AI: The kidney and hypertension in pregnancy. In: “The kidney” (Ed BM Brenner, FC Rector), WB Saunders, Philadelphia, 1991, pp 1551–1595.Google Scholar
  9. 9.
    Hostetter TH: Diabetic nephropathy. In: “The kidney” (Ed BM Brenner, FC Rector), WB Saunders, Philadelphia, 1991, pp 1695–1727.Google Scholar
  10. 10.
    Diederich D: The kidney and sickle cell disease. In: “The principles and practice of nephrology” (Ed HR Jacobson, GE Striker, S Klahr), BC Decker Inc, Philadelphia, Hamilton, 1991, pp 382–387.Google Scholar
  11. 11.
    Bosch JP, Saccaggi A, Lauer A, Ronco C, Belledonne M, Labman S: Renal functional reserve in humans. Effect of protein intake on glomerular filtration rate. Am J Med, 75: 943–950, 1983.PubMedGoogle Scholar
  12. 12.
    Bosch JP, Lauer A, Glabman S: Short-term protein loading in assessment of patients with renal disease. Am J Med, 77: 873–879, 1984.PubMedGoogle Scholar
  13. 13.
    Hirschberg R, Kopple JD: Role of growth hormone in the amino™acid-induced acute rise in renal function in man. Kidney Int, 32: 382–387, 1987.PubMedGoogle Scholar
  14. 14.
    Ruilcpe LM, Rodicio J, Garcia Robles R, Sancho J, Miranda B, Granger JP, Romero JC: Influence of a low sodium diet on the renal response to amino acid infusions in humans. Kidney Int, 31: 992–999, 1987.Google Scholar
  15. 15.
    ter Wee PM, Smit AJ, Rosman JB, Sluiter WJ, Donker AJM: Effect of intravenous infusion of low-dose dopamine on renal function in normal individuals and in patients with renal disease. Am J Nephrol, 6: 42–46, 1986.PubMedGoogle Scholar
  16. 16.
    Dhaene M, Sabot JP, Philippart Y, Doutrelepont JM, Vanherweghem JL: Effects of acute protein loads of different sources on glomerular filtration rate. Kidney Int, 32(suppl 22): S25–S28, 1987.Google Scholar
  17. 17.
    Kontessis P, Jones S, Dodds R, Trevisan R, Nosadini R, Fioretto P, Borsato M, Sacerdoti D, Viberti GC: Renal, metabolic and hormonal responses to ingestion of animal and vegetable proteins. Kidney Int, 38: 136–144, 1990.PubMedGoogle Scholar
  18. 18.
    Jones MG, Lee K, Swaminathan R: The effect of dietary protein on glomerular filtratiom rate in normal subjects. Clin Nephrol, 27: 71–75, 1987.PubMedGoogle Scholar
  19. 19.
    Mansy H, Patel D, Tapson JS, Fernandez J, Tapster S, Torrance AD, Wilkinson R: Four methods to recruit renal functional reserve. Nephrol Dial Transplant, 2: 228–232, 1987.PubMedGoogle Scholar
  20. 20.
    ter Wee PM, Rosman JB, van der Geest S, Sluiter WJ, Donker AJM: Renal haemodynamics during separate and combined infusion of amino acids and dopamine. Kidney Int, 29: 870–874, 1986.PubMedGoogle Scholar
  21. 21.
    Hostetter TH: Human renal response to a meat meal. Am J Physiol, 250: F613–F618, 1986.PubMedGoogle Scholar
  22. 22.
    Castellino P, DeFronzo RA: Effect of plasma amino acid and hormone concentrations on renal plasma flow and glomerular filtration rate. Blood Purification, 6: 240–249, 1988.PubMedGoogle Scholar
  23. 23.
    Castellino P, Giordano C, Perna A, DeFronzo RA: Effects of plasma amino acids and hormone levels on renal hemodynamics in humans. Am J Physiol, 255: F444–F449, 1988.PubMedGoogle Scholar
  24. 24.
    Castellino P, Coda B, DeFronzo RA: Effect of amino acid infusion on renal hemodynamics in humans. Am J Physiol, 251: F132–F140, 1986.PubMedGoogle Scholar
  25. 25.
    ter Wee PM, Geerlings W, Rosman JB, Sluiter WJ, van der Geest S, Donker AbJM: Testing renal reserve filtration capacity with an amino acid solution. Nephron, 41: 193–199, 1985.PubMedGoogle Scholar
  26. 26.
    Viberti G, Bognetti E, Wiseman MJ, Dodds R, Gross JL, Keen H: Effect of protein-restricted diet on renal response to a meat meal in humans. Am J Physiol, 253: F388–F393, 1987.PubMedGoogle Scholar
  27. 27.
    Hirschberg RR, Zipser RD, Slomowitz LA, Kopple JD: Glucagon and prostaglandins are mediators of amino acid-induced rise in renal hemodynamics. Kidney Int, 33: 1147–1155, 1988.PubMedGoogle Scholar
  28. 28.
    Krishna GG, Newell G, Miller E, Heeger P, Smith R, Polansky M, Kapoor S, Hoeldtke R: Protein-induced glomerular hyperfiltration: Role of hormone factors. Kidney Int, 33: 578–583, 1988.PubMedGoogle Scholar
  29. 29.
    Swainson CP, Walker RJ: Renal Haemodynamic and hormonal responses to a mixed high-protein meal in normal men. Nephrol Dial Transplant 4: 683–690, 1989.PubMedGoogle Scholar
  30. 30.
    Rodríguez-Iturbe B, Herrera J, García R: Relationship between glomerular filtration rate and renal blood flow at different levels of protein induced hyperfiltration in man. Clin Sci, 74: 11–15, 1988.PubMedGoogle Scholar
  31. 31.
    Rodríguez-Iturbe B: The renal response to an acute protein load in man: Clinical perspective. Nephrol Dial Transplant, 5: 1–9, 1990.PubMedGoogle Scholar
  32. 32.
    Gabbai F, Herrera-Acosta J: Es la lesion renal por hypertension realmente isquemica? Arch Inst Cardiol Mex, 56: 81–87, 1986.PubMedGoogle Scholar
  33. 33.
    Herrera-Acosta J, Reyes P, Manay GL, Perez-Grovas H: La inhibición de la síntesis de prostaglandinas suprime la reserva functional renal en pacientes con nefropatía lúpica. Rev Invest Clin, 39: 107–114, 1987.PubMedGoogle Scholar
  34. 34.
    Chan AYM, Cheng MLL, Keil LC, Myers BD: Functional response of healthy and diseased glomeruli to a large, protein rich meal. J Clin Invest, 81: 245–254, 1988.PubMedGoogle Scholar
  35. 35.
    Meyer TW, Ichikawa I, Zatz R, Brenner BM: The renal hemodynamic response to amino acid infusion in the rat. Trans Assoc Am Phys, 96: 76–83, 1983.PubMedGoogle Scholar
  36. 36.
    Baylis C: Effect of amino acid infusion as an index of renal vasodilatory capacity in pregnant rats. Am J Physiol, 254: F650–F656, 1988.PubMedGoogle Scholar
  37. 37.
    Gabbai FB, Tapia E, Cermeño JL, Romero L, Bobadilla N, Alvarado JA, Herrera-Acosta J: Evaluation of renal functional reserve of contralateral kidney of two kidney, one clip Goldblatt hypertensive rats. J Hypertension, 4(suppl 5): S279–S281, 1986.Google Scholar
  38. 38.
    Woods LL, Mizelle HL, Montani J, Hall J: Mechanisms controlling renal hemodynamics and electrolyte excretion during amino acids. Am J Physiol, 252: F303–F312, 1986.Google Scholar
  39. 39.
    Brown SA, Navar LG: Single nephron responses to systemic administration of amino acids in dogs. Am J Physiol, 259: F739–F746, 1990.PubMedGoogle Scholar
  40. 40.
    Ikkos D, Ljunggren R, Luft R: Glomerular filtration and renal plasma flow in acromegaly. Acta Endocrinol, 21: 226–236, 1957.Google Scholar
  41. 41.
    Christiansen JS, Gammelgaard J, Orskov H, Andersen AR, Telmer S, Parving HH: Kidney function and size in normal subjects before and during growth hormone administration for one week. Eur J Clin Invest, 11: 487–490, 1962.Google Scholar
  42. 42.
    Kleinman KS, Glassock RJ: Glomerular filtration rate fails to increase following protein ingestion in hypothalamo-hypophyseal-deficient adults. Am J Nephrol, 6: 169–174, 1986.PubMedGoogle Scholar
  43. 43.
    Ruilope L, Rodicio J, Miranda B, Garcia Robles R, Sancho-Rof J, Romero JC: Renal effects of amino acid infusions in patients with panhypopituitarism. Hypertension, 11: 557–559, 1988.PubMedGoogle Scholar
  44. 44.
    Brouhard BH, La Grone LF, Richards GE, Travis LB: Somatostatin limits rise in glomerular filtration rate after a protein meal. J Pediatr, 110: 729–734, 1987.PubMedGoogle Scholar
  45. 45.
    Brouhard BH, Richards GE: Effects of growth hormone on the glomerular filtration response to a protein meal. J Am Coll Nutr, 8: 57–60, 1989.PubMedGoogle Scholar
  46. 46.
    Bergstrom J, Ahlberg M, Alvestrand A: Influence of protein intake on renal hemodynamics and plasma hormone concentrations in normal subjects. Acta Med Scand, 217: 189–196, 1985.PubMedGoogle Scholar
  47. 47.
    Hirschberg R, Kopple JD: Increase in renal plasma flow and glomerular filtration rate during growth hormone treatment may be mediated by insulin-like growth gactor 1. Am J Nephrol, 8: 249–253, 1988.PubMedGoogle Scholar
  48. 48.
    Hirschberg R, Raab H, Bergamo R, Kopple JD: The delayed effect of growth hormone on renal function in man. Kidney Int, 35: 865–870, 1989.PubMedGoogle Scholar
  49. 49.
    Parving HH, Noer J, Mogensen CE, Svendsen PA: Kidney function in normal man during short-term growth hormone infusion. Acta Endocrinol (Copenh), 89: 796–800, 1978.Google Scholar
  50. 50.
    Premen AJ: Protein-mediated elevations in renal hemodynamics: Existence of a hepato-renal axis? Medical Hypotheses, 19:295–309, 1986.PubMedGoogle Scholar
  51. 51.
    Premen AJ, Hall JE, Smith MJ: Postprandial regulation of renal hemodynamics: role of pancreatic glucagon. Am J Physiol, 248: F656–F662, 1985.PubMedGoogle Scholar
  52. 52.
    Uranga J, Fuenzalida R, Rapoport AL, del Castillo E: Effect of glucagon and glomerulopressin on the renal function of the dog. Horm Metab Res, 11: 275–279, 1979.PubMedGoogle Scholar
  53. 53.
    Alvestrand A, Bergstrom J: Glomerular hyperfiltration after protein ingestion, during glucagon infusion, and in insulin-dependent diabetes is induced by a liver hormone: deficient production of this hormone in hepatic failure causes hepatorenal syndrome. Lancet I: 195–197, 1984.Google Scholar
  54. 54.
    Alverstrand A, Zimmerman L, Bergstrom J: Potential role of a liver-derived factor in mediating renal response to protein. Blood Purification, 6: 276–284, 1988.Google Scholar
  55. 55.
    Juncos LI, Salom MG, Cornejo JC, Romero JC: Renal response to amino acid infusion in essential hypertension. J Am Soc Nephrol 1: 507, 1990 (Abstract).Google Scholar
  56. 56.
    Slomowitz LA, Hirschberg R, Kopple JD: Captopril augments the renal response to an amino acid infusion in diabetic adults. Am J Physiol 255: F755–F762, 1988.PubMedGoogle Scholar
  57. 57.
    Chagnac A, Gafter U, Zevin D, Hirsch Y, Markovitz I, Levi J: Enalapril attenuates glomerular hyperfiltration following a meat meal. Nephron, 51: 466–469, 1989.PubMedGoogle Scholar
  58. 58.
    Hirschberg R, Kopple JD: Evidence that insulin-like growth factor 1 increases renal plasma flow and glomerular filtration rate in fasted rats. J Clin Invest, 83: 326–330, 1989.PubMedGoogle Scholar
  59. 59.
    Hirschberg R, Kopple JD, Blantz RC, Tucker BJ: Effects of IGF-1 on glomerular hemodynamics in rats. J Am Soc Nephrol, 1: 666, 1990 (Abstract).Google Scholar
  60. 60.
    Guler HP, Eckardt KU, Zapf J, Bauer C, Froesch ER: Insulin-like growth factor 1 increases glomerular filtration rate and renal plasma flow in man. Acta Endocrinol (Copenh), 121: 101–106, 1989.Google Scholar
  61. 61.
    Haylor J, Singh I, El Nahas AM: Nitric oxide synthesis inhibitor prevents vasodilation by insulinlike growth factor 1. Kidney Int, 39: 333–335, 1991.PubMedGoogle Scholar
  62. 62.
    Rodríguez-Iturbe B, Herrera J, Gutkowska J, Parra G, Coello J: Atrial natriuretic factor increases after a protein meal in man. Clin Sci, 75: 495–498, 1988.PubMedGoogle Scholar
  63. 63.
    Vanrenterghem YFCh, Verberckmoes RKA, Roels LM, Michielsen PJ: Role of prostaglandins in protein-induced glomerular hyperfiltration in normal humans. Am J Physiol, 254: F463–F469, 1988.PubMedGoogle Scholar
  64. 64.
    Herrera J, Rodríguez-Iturbe B, Parra G, Coello J, García R, Colina-Chourio J, Sinaiko A: Urinary prostaglandin E and kallikrein activity in glomerular hyperfiltration induced by a meat meal in man. Clin Nephrol, 30: 151–157, 1988.PubMedGoogle Scholar
  65. 65.
    Brouhard BH, La Grone L: Effect of indomethacin on the glomerular filtration rate after a protein meal in humans. Am J Kidney Dis, 13: 232–236, 1989.PubMedGoogle Scholar
  66. 66.
    Moncada S, Palmer RMJ, Higgs EA: Biosynthesis of nitric oxide from L-arginine. A pathway for the regulation of cell function and communication. Biochem Pharmacol, 38: 1709–1715, 1989.PubMedGoogle Scholar
  67. 67.
    Marsden PA, Goligorsky MS, Brenner BM: Endothelial cell biology in relation to current concepts of vessel wall structure and function. J Am Soc Nephrol, 1: 931–948, 1991.PubMedGoogle Scholar
  68. 68.
    King AJ, Troy JL, Downes SJ, Anderson S, Brenner BM: Effects of N-monomethyl-L-arginine (L-NMMA) on the basal renal hemodynamics response and the response to amino acid infusion. Kidney Int, 37: 371A, 1990 (Abstract).Google Scholar
  69. 69.
    Baines AD, Ho P, James H: Metabolic control of renal vascular resistance and glomerulotubular balance. Kidney Int, 27: 848–854, 1985.PubMedGoogle Scholar
  70. 70.
    Ferrano RG, Salvati P: Intrarenal production of endothelium-derived nitric oxide (NO) modulate renal hemodynamics. J Am Soc Nephrol 1: 664, 1990 (Abstract).Google Scholar
  71. 71.
    Don BR, Sechi LA, Schambelan M: Dietary protein modulates glomerular cGMP via endothelium-derived relaxing factor (EDRF): a possible mediator of glomerular hyperfiltration. J AM Soc Nephrol 1: 441, 1990 (Abstract).Google Scholar
  72. 72.
    Bolin P, Jaffa AA, Rust PF, Mayfield RK: Acute and chronic responses of human renal kallikrein and kinins to dietary protein. Am J Physiol, 257: F718–F723, 1989.PubMedGoogle Scholar
  73. 73.
    Jaffa AA, Stewart JM, Vavrek RJ, Rust PF, Mayfield RK: A bradykinin inhibitor prevents the increase in glomerular filtration rate induced by amino acids. Clin Res 37: 492A, 1989.Google Scholar
  74. 74.
    De Nicola L, Blantz RC, Gabbai FB: Renal functional reserve in treated and untreated hypertensive rats. Kidney Int (in press).Google Scholar
  75. 75.
    Gabbai FB, De Nicola L, Blantz RC: Renal functional reserve in rats with recent onset poorly controlled diabetes mellitus. J Am Soc Nephrol 1: 664, 1990 (Abstract).Google Scholar
  76. 76.
    Claris Appiani A, Assael BM, Tirelli AS, Cavanna G, Corbetta C, Marra G: Proximal tubular function and hyperfiltration during amino acid infusion in man. Am J Nephrol, 8: 96–101, 1988.PubMedGoogle Scholar
  77. 77.
    Cassidy MJD, Beck R: Renal functional reserve in live related kidney donors. Am J Kidney Dis, 11: 468–472, 1988.PubMedGoogle Scholar
  78. 78.
    Amore A, Coppo R, Roccatello D, Martina G, Rollino C, Basolo B, Novelli F, Amprimo MC, Cavalli G, Piccoli G: Single kidney function: Effect of acute protein and water loading on microalbuminuria. Am J Med, 84: 711–717, 1988.PubMedGoogle Scholar
  79. 79.
    ter Wee PM, Tegzess AM, Donker AJM: The effect of low dose dopamine on renal function in uninephrectomized patients: special emphasis on kidney donors before and after nephrectomy. Clin Nephrol, 28: 211–216, 1987.PubMedGoogle Scholar
  80. 80.
    Rodríguez-Iturbe B, Herrera J, García R: Response to acute protein load in kidney donors and in apparently normal postacute glomerulonephritis patients: Evidence for glomerular hyperfiltration. Lancet, August 31: 461–464, 1985.Google Scholar
  81. 81.
    Tufro A, Arrizurieta E, Repetto H, Dieguez SM, Picon A: Renal response to a protein meal in children with single kidneys. Clin Nephrol, 34: 17–21, 1990.PubMedGoogle Scholar
  82. 82.
    Rugiu C, Oldrizzi L, Maschio G: Effects of an oral protein load on glomerular filtration rate in patients with solitary kidneys. Kidney Int, 32(suppl 22): S29–S31, 1987.Google Scholar
  83. 83.
    Wheeler DC, Cosgriff PS, Bennett SE, Walls J: Measurement of renal functional reserve of the single kidney in man. Clin Nephrol, 28: 87–92, 1987.PubMedGoogle Scholar
  84. 84.
    Tapson JS, Mansy H, Marshall SM, Tisdall SR, Wilkinson R: Renal functional reserve in kidney donors. Quart J Med, 60: 725–732, 1986.PubMedGoogle Scholar
  85. 85.
    Zuccala A, Gaggi R, Zucchelli A, Zucchelli P: Renal functional reserve in patients with a reduced number of functioning glomeruli. Clin Nephrol, 32: 229–234, 1989.PubMedGoogle Scholar
  86. 86.
    Molina E, Herrera J, Rodríguez-Iturbe B: The renal functional reserve in health and renal disease in shool age children. Kidney Int, 34: 809–816, 1988.PubMedGoogle Scholar
  87. 87.
    De Santo NG, Capasso G, Anastasio P, Coppola S, Castellino P, Lama G, Bellini L: The renal hemodynamic response following a meat meal in children with chronic renal failure and in healthy controls. Nephron, 56: 136–142, 1990.PubMedGoogle Scholar
  88. 88.
    Krishna GG, Kapoor SC: Preservation of renal reserve in chronic renal disease. Am J Kidney Dis, 17: 18–24, 1991.PubMedGoogle Scholar
  89. 89.
    Notghi A, Anderton JL: Effect of nifedipine and mefruside on renal reserve in hypertensive patients. Postgrad Med J, 64: 856–859, 1988.PubMedGoogle Scholar
  90. 90.
    Losito A, Zampi I, Fortunati I, del Favero A: Glomerular hyperfiltration and albuminuria in essential hypertension. Nephron, 49: 84–85, 1988.PubMedGoogle Scholar
  91. 91.
    Valvo E, Casagrande P, Bedogna V, Dal Santo F, Alberti D, Fontanarosa C, Braggio P, Maschio G: Renal functional reserve in patients with essential hypertension: effect of inhibition of the renin-angiotensin system. Clin Sci, 78: 585–590, 1990.PubMedGoogle Scholar
  92. 92.
    Cairns HS, Raval U, Neild GH: Failure of cyclosporine-treated renal allograft recipients to increase glomerular filtration rate following an amino acid infusion. Transplantation, 46: 79–82, 1988.PubMedGoogle Scholar
  93. 93.
    Bochicchio T, Sandoval G, Ron H, Pérez-Grovas H, Bordes J, Herrera-Acosta J: Fosinopril prevents hyperfiltration and decreases proteinuria in post-transplant hypertensives. Kidney Int, 38: 873–879, 1990.PubMedGoogle Scholar
  94. 94.
    Fioretto P, Trevisan R, Valerio A, Avogaro A, Borsaio M, Doria A, Semplicini A, Sacerdoti D, Jones S, Bognetti E, Viberti GC, Nosadini R: Impaired renal response to a meat meal in insulin-dependent diabetes: role of glucagon and prostaglandins. Am J Physiol, 258: F675–F683, 1990.PubMedGoogle Scholar
  95. 95.
    Brouhard BH, La Grone LF, Richards GE, Travis LB: Short term protein loading in diabetics with a ten-year duration of disease. AJCD, 140:473–476, 1986.Google Scholar
  96. 96.
    Castellino P, De Santo NG, Capasso G, Anastasio P, Coppola S, Capodicasa G, Perna A, Torella R, Salvatore T, Giordano C: Low protein alimentation normalizes renal haemodynamic response to acute protein ingestion in type 1 diabetic children. Eur J Clin Invest, 19, 78–83, 1989.PubMedGoogle Scholar
  97. 97.
    Eisenhauer T, Jungmann E, Warneboldt D, Ansorge G, Scherberich J, Talartschik: Renal functional reserve in type 1 diabetics: Effect of ACE-inhibition. Kin Wochenschr, 68, 750–757, 1990.Google Scholar
  98. 98.
    Tuttle K, Perusek M, DeFronzo R, Kunau R: Increased renal reserve and size regress with strict glycemic control in insulin dependent diabetes mellitus. Kidney Int 37: 261, 1990 (Abstract).Google Scholar
  99. 99.
    Bruton JL, Perusek MC, Lancaster JL, Kopp DT, Tuttle KR: Effects of glycemia on basal and amino acid stimulated renal hemodynamics and kidney size in non-insulin dependent diabetes (NIDD). J Am Soc Nephrol, 1: 623, 1990 (Abstract).Google Scholar
  100. 100.
    Baylis C: Immediate and long term effects of pregnancy on glomerular function in the SHR. Am J Physiol, 257: F1140–F1145, 1989.PubMedGoogle Scholar
  101. 101.
    Herrera-Acosta J, Tapia E, Bobadilla NA, Romero L, Cermeño JL, Alvarado JA, Gabbai FB: Evaluating hyperfiltration with glycine in hypertensive rats with renal ablation. Hypertension, 11(suppl 1): 133–137, 1988.Google Scholar
  102. 102.
    Tapia E, Bobadilla N, Romero L, Amato D, Herrera-Acosta: Reduction of arterial pressure after removing the clip restores renal functional reserve in Goldblatt hypertensive rats with renal ablation. Kidney Int, 35: 336A, 1989 (Abstract).Google Scholar
  103. 103.
    Tapia E, Gabbai FB, Calleja C, Franco M, Cermeño JL, Bobadilla NA, Pérez JM, Alvarado JA, Herrera-Acosta J: Determinants of renal damage in rats with systemic hypertension and partial renal ablation. Kidney Int, 38: 642–648, 1990.PubMedGoogle Scholar

Copyright information

© Springer-Verlag London Limited 1991

Authors and Affiliations

  • Francis B. Gabbai
    • 1
  • Luca De Nicola
    • 1
  • Roland C. Blantz
    • 1
  1. 1.Division of Nephrology-HypertensionUniversity of California, San Diego School of Medicine and Veterans Affairs Medical CenterLa JollaUSA

Personalised recommendations