Fotino S
Department of Medicine, Albert Einstein College of Medicine, Bronx, NY.
Am J Kidney Dis. 1989 Feb;13(2):88-98. doi: 10.1016/s0272-6386(89)80124-6.
Reduction of renal mass (11/12) in rats leads to progressive azotemia, proteinuria, and hypertension. Less extensive renal ablation resulting from uninephrectomy also accelerates the progression of focal glomerulosclerosis (FGS) induced by experimental diabetes, renal irradiation, aminonucleoside nephrosis, or aging. The consequence of the absence of one kidney in man are examined in three different clinical situations. Unilateral renal agenesis seems to predispose to the development of FGS, but most reports include isolated cases and the true incidence of FGS is not known. The solitary kidney following uninephrectomy for acquired unilateral disease undergoes a compensatory rise in glomerular filtration rate (GFR) that remains stable for several decades. Finally, kidney donors followed for over 2 decades show unimpaired GFR, elevated at 70% to 80% of the normal (two-kidney) GFR. Some donors develop mild, nonprogressive proteinuria. Their incidence of hypertension matches that in the control population. Thus, hyperfiltration secondary to 50% reduction of renal mass in humans does not lead to loss of function of the remaining parenchyma.
大鼠肾质量减少（切除11/12）会导致进行性氮质血症、蛋白尿和高血压。单侧肾切除导致的肾实质切除范围较小，也会加速由实验性糖尿病、肾脏照射、氨基核苷肾病或衰老引起的局灶性肾小球硬化（FGS）的进展。在三种不同的临床情况下研究了人类单侧肾缺如的后果。单侧肾发育不全似乎易患FGS，但大多数报告为个别病例，FGS的真实发病率尚不清楚。因后天性单侧疾病行单侧肾切除术后的孤立肾，肾小球滤过率（GFR）会出现代偿性升高，并在几十年内保持稳定。最后，随访超过20年的肾脏供体显示GFR未受损，其GFR升高至正常（双肾）GFR的70%至80%。一些供体出现轻度、非进行性蛋白尿。他们的高血压发病率与对照组人群相当。因此，人类肾质量减少50%继发的高滤过不会导致剩余肾实质功能丧失。
