Originariamente Scritto da Luigi 87
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Glomerular hyperfiltration: definitions, mechanisms and clinical implications
Imed Helal, Godela M. Fick-Brosnahan, Berenice Reed-Gitomer & Robert W. Schrier
Abstract
Glomerular hyperfiltration is a phenomenon that can occur in various clinical conditions including kidney disease. No single definition of glomerular hyperfiltration has been agreed upon, and the pathophysiological mechanisms, which are likely to vary with the underlying disease, are not well explored. Glomerular hyperfiltration can be caused by afferent arteriolar vasodilation as seen in patients with diabetes or after a high-protein meal, and/or by efferent arteriolar vasoconstriction owing to activation of the renin–angiotensin–aldosterone system, thus leading to glomerular hypertension. Glomerular hypertrophy and increased glomerular pressure might be both a cause and a consequence of renal injury; understanding the renal adaptations to injury is therefore important to prevent further damage. In this Review, we discuss the current concepts of glomerular hyperfiltration and the renal hemodynamic changes associated with this condition. A physiological state of glomerular hyperfiltration occurs during pregnancy and after consumption of high-protein meals. The various diseases that have been associated with glomerular hyperfiltration, either per nephron or per total kidney, include diabetes mellitus, polycystic kidney disease, secondary focal segmental glomerulosclerosis caused by a reduction in renal mass, sickle cell anemia, high altitude renal syndrome and obesity. A better understanding of the mechanisms involved in glomerular hyperfiltration could enable the development of new strategies to prevent progression of kidney disease.
Sottolineo due cose:
Si parla chiaramente di stato fisiologico neanche subclinico, ovvero che possa presagire ad una patologia
E poi si parla di singolo pasto ad alte proteine non di dieta iperproteica in generale, e che significa pasto iperproteico 30g, 40, 50g non so, e si si fanno tanti pasti da 20g?
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