RAZISKOVALNI IN KLINIČNI POMEN MERJENJA LEDVIČNE FUNKCIJSKE REZERVE
Ključne besede:
ledvična funkcijska rezerva, glomerulna filtracija, arterijska hipertenzija, sladkorna bolezen, aterosklerozaPovzetek
Izhodišča. Ledvična funkcijska rezerva (LFR) je prehodno zvečanje glomerulne filtracije, ki ga izzovemo s proteinskim obrokom ali infuzijo aminokislin. Je ledvični vazodilatacijski odziv, za katerega je verjetno odgovornih več posrednikov, med najpomembnejše spada dušikov monoksid. Izboljšanje metod za natančno in časovno primerno merjenje hitrosti glomerulne filtracije (GFR) je v zadnjem času omogočilo pomemben napredek pri merjenju LFR. Uveljavlja se metoda merjenja GFR prek izračuna klirensa sinistrina po bolusnem odmerku tega markerja.
Zaključki. V članku predstavljava rezultate novejših raziskav LFR s to metodo in jih primerjava s starejšimi raziskavami. Na spremembe LFR vplivajo različna patofiziološka stanja: arterijska hipertenzija, sladkorna bolezen, slabšanje delovanja presajene ledvice. Članek podaja pregled izsledkov in pomena merjenja LFR pri teh stanjih. Na koncu obravnava možnosti za nadaljnje raziskave LFR pri aterosklerotični prizadetosti žilja. Točno merjenje LFR je pomembno za ugotavljanje zgodnjih bolezenskih sprememb ledvične hemodinamike, na katere lahko vplivamo z zdravljenjem in tako preprečimo ali vsaj upočasnimo slabšanje ledvične funkcije.
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