Rodríguez-Iturbe B, Herrera J, García R
Lancet. 1985 Aug 31;2(8453):461-4. doi: 10.1016/s0140-6736(85)90399-x.
25 kidney donors who had undergone nephrectomy 1-11 years ago, 35 patients followed up for 13 years after poststreptococcal glomerulonephritis, and 44 controls were investigated for their capacity to increase their glomerular filtration rate after an acute oral load of 100-150 g of protein. Their mean baseline creatinine clearances (Ccrl, ml/min +/- SEM) were similar (controls 108.5 +/- 6.1; kidney donors 115.4 +/- 8.54; postacute nephritis 82.0 +/- 6.45), but the postmeal filtration rates (Ccr2) were significantly (p less than 0.05) lower in the two patient groups (kidney donors 137.4 +/- 11.60; postacute nephritis 90.3 +/- 5.30) than in the controls (161.5 +/- 9.39), as was the Ccr2/Ccr1 ratio (p less than 0.01, controls 1.58 +/- SEM 0.10; kidney donors 1.20 +/- 0.07; postacute nephritis 1.18 +/- 0.08). In normal individuals the degree of change was inversely related to the initial creatinine clearance and varied from 135.6% +/- 43.0 when Ccrl was less than 70 ml/min to 32.7% +/- 9.50 when Ccrl was 130 ml/min or higher. This relative response was decreased in kidney donors and postacute nephritis patients. Kidney donors and apparently normal postacute nephritis patients thus have diminished renal reserve capacity.
对25名在1 - 11年前接受过肾切除术的肾脏捐献者、35名在链球菌感染后肾小球肾炎发病13年后接受随访的患者以及44名对照者，研究了他们在急性口服100 - 150克蛋白质负荷后增加肾小球滤过率的能力。他们的平均基线肌酐清除率（Ccrl，毫升/分钟±标准误）相似（对照者108.5±6.1；肾脏捐献者115.4±8.54；急性肾炎后患者82.0±6.45），但两组患者（肾脏捐献者137.4±11.60；急性肾炎后患者90.3±5.30）餐后滤过率（Ccr2）显著低于（p<0.05）对照者（161.5±9.39），Ccr2/Ccr1比值也是如此（p<0.01，对照者1.58±标准误0.10；肾脏捐献者1.20±0.07；急性肾炎后患者1.18±0.08）。在正常个体中，变化程度与初始肌酐清除率呈负相关，当Ccrl低于70毫升/分钟时为135.6%±43.0，当Ccrl为130毫升/分钟或更高时为32.7%±9.50。肾脏捐献者和急性肾炎后患者的这种相对反应降低。因此，肾脏捐献者和明显正常的急性肾炎后患者的肾脏储备能力降低。
