慢性肾衰竭时肾小球滤过率降低的肾小管代偿——临床药理学视角

Tubular compensation for glomerular filtration rate decrease in chronic renal failure - the clinicopharmacologic point of view.

作者信息

Schück O, Nádvorníková H, Teplan V

出版信息

Int J Clin Pharmacol Ther Toxicol. 1981 Aug;19(8):335-40.

Abstract

The decrease of GFR can be compensated for by the tubular functions of residual nephrons while the homeostasis of the internal milieu is maintained. A new method presented here enables us to estimate the adequacy of tubular compensation on the basis of investigations of fractional excretion (FE) of sodium, water, and potassium. If the extrarenal excretion of the determined substance is small in comparison with the intake (I), the adequate value of FE with respect to GFR and I can be calculated according to the following formula: FE = 1.15 I/GFR . S. In patients with GFR less than 0.17 ml/s, FENa reached the values of 20-25%, FEH2O: 30-35%, and FEK: 150-200%. The estimation of these parameters can help in indicating and controlling therapy by diuretics and dietary restrictions.

摘要

肾小球滤过率（GFR）的降低可由残余肾单位的肾小管功能进行代偿，同时维持内环境的稳态。本文介绍的一种新方法能让我们基于对钠、水和钾的分数排泄（FE）的研究来评估肾小管代偿是否充分。如果所测物质的肾外排泄量与摄入量（I）相比很小，那么关于GFR和I的FE适宜值可根据以下公式计算：FE = 1.15 I/GFR 。S。在GFR低于0.17 ml/s的患者中，FENa达到20 - 25%的值，FEH2O为30 - 35%，FEK为150 - 200%。对这些参数的评估有助于指导和控制利尿剂治疗及饮食限制。