Protecting the residual renal function: Which drugs of choice?

Drugs affecting the renin-angiotensin system and preservation of residual renal function in dialysis patients.

OBJECTIVES Residual renal function (RRF) is of paramount importance to dialysis adequacy, morbidity, and mortality, particularly for long-term continuous ambulatory peritoneal dialysis (CAPD) patients. Residual renal function seems to be better preserved in patients on CAPD than in hemodialysis (HD) patients. We analyzed RRF in 45 patients with end-stage renal disease (ESRD), commencing either ...

Rapid loss of renal function due to obstruction: minimal residual activity

A man with metastatic carcinoma of the colon had a bone scan which revealed urinary retention in the left kidney. Ten months later, a Tc-99m-DTPA renai glomerular study showed the left kidney to have only 8% of total renal function. Fifteen months after that, (he same kidney demonstrated 9% of total function, while the right kidney had evolving obstruction due to his neoplasm. The case sh...

Acute kidney injury and residual renal function

Acute kidney injury (AKI) occurring in patients admitted to the ICU may result in impaired renal function on long-term follow-up after ICU discharge. The damage induced by subclinical or manifest episodes of AKI may, in fact, produce an irreversible loss of a variable amount of renal mass with deleterious effects on overall renal function. This may be the case even though baseline glomerular fi...

Residual Renal Function in Hemodialysis Patients

The natural history of residual renal function in transplant donors.

After uninephrectomy, GFR in the remaining kidney increases to 60%-70% of the predonation value, largely because of a substantial increase in renal blood flow. Donor kidney function is then generally maintained over many years. Hypertension and proteinuria are common among living donors but do not appear to negatively affect long-term renal function. Loss of reserve capacity regarding renal fun...