Determination of Renal Reserve Capacity by Identification of Kinetic Systems

S. Zitta, K. Stoschitzky, R. Zweiker, T. Lang, Harry Holzer, F. Mayer, G. Reibnegger and W. Estelberer

Mathematical and Computer Modelling of Dynamical Systems, 2000, vol. 6, issue 2, 190-207

Abstract: A method of adapting two-compartment models to dynamic marker concentration profiles for the determination of renal clearance and of its acute changes due to protein ingestion in patients with essential hypertension is described. In 9 healthy controls glomerular filtration rates (GFR) and effective renal plasma flows (ERPF) (ml/min/1.73 m2; means +/- sd) rose significantly tested pairwise from 118.2 +/- 13.9 to 139.5 +/- 30.9, p = 0.023 and from 503.2 +/- 75.6 to 558.3 +/- 96.2, p = 0.013, respectively. Four patients with mild hypertension and mean arterial pressure (MAP) of 106 +/- 3 mmHg (duration = 13.8 +/- 10.3 years) showed rises in GFR (73.9 +/- 14.7 to 83.6 +/- 17.4, p = 0.034) after stimulation, whereas 6 patients with a MAP of 119 +/- 3 mmHg (duration = 17.5 +/- 13.7 years) exhibited ‘paradoxical’ decreases in GFR (113.3 +/- 18.7 to 103.0 +/- 14.3, p = 0.037). The ERPFs showed nonsignificant changes in the first group of patients (277.8 +/- 52.6 to 323.9 +/- 42.8), whereas the second group revealed increases in ERPF (430.7 +/- 134.5 to 502.3 +/- 113.1, p = 0.013). All patients had normal serum creatinine levels. The study demonstrates that modern system identification of kinetic experiments, but not traditional techniques relying on steady-state data, allow one to detect such dynamic alterations as measures of renal functional reserve.

Date: 2000
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DOI: 10.1076/1387-3954(200006)6:2;1-M;FT190

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