Journal article

Renal functional reserve: from physiological phenomenon to clinical biomarker and beyond

Alemayehu H Jufar, Yugeesh R Lankadeva, Clive N May, Andrew D Cochrane, Rinaldo Bellomo, Roger G Evans

AJP Regulatory Integrative and Comparative Physiology | AMER PHYSIOLOGICAL SOC | Published : 2020

Abstract

Glomerular filtration rate (GFR) is acutely increased following a high-protein meal or systemic infusion of amino acids. The mechanisms underlying this renal functional response remain to be fully elucidated. Nevertheless, they appear to culminate in preglomerular vasodilation. Inhibition of the tubuloglomerular feedback signal appears critical. However, nitric oxide, vasodilator prostaglandins, and glucagon also appear important. The increase in GFR during amino acid infusion reveals a “renal reserve,” which can be utilized when the physiological demand for single nephron GFR increases. This has led to the concept that in subclinical renal disease, before basal GFR begins to reduce, renal f..

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Grants

Awarded by National Health and Medical Research Council of Australia


Awarded by National Heart Foundation of Australia


Funding Acknowledgements

The authors' work was supported by National Health and Medical Research Council of Australia Grants GNT1122455, GNT1185777, and GNT1188514 and National Heart Foundation of Australia Grant 101853. A. H. Jufar was supported by a postgraduate scholarship from Monash University.