Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
Adv Chronic Kidney Dis. 2018 May;25(3):e1-e8. doi: 10.1053/j.ackd.2018.03.001.
Kidney function, like the function of other organs, is dynamic and continuously adjusts to changes in the internal environment to maintain homeostasis. The glomerular filtration rate, which serves as the primary index of kidney function in clinical practice, increases in response to various physiological and pathological stressors including oral protein intake. The difference between the glomerular filtration rate in the resting state and at maximum capacity has been termed renal functional reserve (RFR). RFR could provide additional information on kidney health and renal function prognosis. Despite longstanding interest in RFR as a biomarker in nephrology, its underlying mechanisms remain inadequately understood. Moreover, no consensus has been reached on how it should be quantified. Previous studies on RFR have used various measurement methods and yielded heterogeneous results. A standardized and clinically feasible approach to quantifying RFR would allow for more rigorous appraisal of its value as a biomarker and could pave the way for adoption of "renal stress tests" into clinical practice.
肾脏功能与其他器官的功能一样，是动态的，会不断适应内部环境的变化以维持体内平衡。肾小球滤过率是临床实践中评估肾脏功能的主要指标，它会随着各种生理和病理应激源的变化而增加，包括口服蛋白质摄入。肾小球滤过率在静息状态和最大能力之间的差异被称为肾脏功能储备（RFR）。RFR 可以提供有关肾脏健康和肾功能预后的额外信息。尽管 RFR 作为肾脏病学的生物标志物一直备受关注，但它的潜在机制仍未得到充分理解。此外，对于如何对其进行量化也没有达成共识。之前关于 RFR 的研究使用了各种测量方法，得出的结果也存在差异。一种标准化且临床可行的 RFR 定量方法可以更严格地评估其作为生物标志物的价值，并为将“肾脏压力测试”应用于临床实践铺平道路。
