Kimura Genjiro
Department of Internal Medicine and Pathophysiology, Nagoya City University Graduate School of Medical Sciences, Mizuho-cho, Mizuho-ku, Nagoya 467-8601, Japan.
Clin Exp Nephrol. 2005 Jun;9(2):102-13. doi: 10.1007/s10157-005-0353-z.
In clinical nephrology, the glomerular filtration rate (GFR) has been recognized as the golden standard to assess renal function. However, a normal GFR does not necessarily mean normal filtration capability of the kidneys, because impaired filtration capability can be compensated for by elevating glomerular hydraulic pressure. Therefore, an early phase of glomerular dysfunction cannot be detected by the baseline GFR alone. On the other hand, glomerular capillary hypertension is widely recognized as one of the strong risk factors for the progression of nephropathies. Now, it is very important to imagine glomerular hemodynamics in each patient with nephropathy for detecting early dysfunction, as well as for evaluating risk factors. Here, I would like to summarize the current status of how an early phase of renal dysfunction can be detected in clinical practice. I truly anticipate that new methods to assess glomerular hemodynamics in humans will be developed in the near future.
在临床肾脏病学中，肾小球滤过率（GFR）已被公认为评估肾功能的金标准。然而，正常的GFR并不一定意味着肾脏的滤过能力正常，因为滤过能力受损可通过升高肾小球液压来代偿。因此，仅通过基线GFR无法检测到肾小球功能障碍的早期阶段。另一方面，肾小球毛细血管高压被广泛认为是肾病进展的重要危险因素之一。现在，对于每位肾病患者而言，设想其肾小球血流动力学对于检测早期功能障碍以及评估危险因素都非常重要。在此，我将总结在临床实践中如何检测肾功能障碍早期阶段的现状。我真心期待在不久的将来能够开发出评估人体肾小球血流动力学的新方法。
