1995 Fiscal Year Final Research Report Summary
The study o renal disease in patients with vesicoureteral reflux
| Project/Area Number |
05671344
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| Research Category |
Grant-in-Aid for General Scientific Research (C)
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| Allocation Type | Single-year Grants |
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| Research Field |
Urology
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| Research Institution | Fukuoka University |
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Principal Investigator |
OSHIMA Kazuhiro Fukuoka Univ., Sch. of Medicine, Prof., 医学部, 教授 (30078795)
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| Co-Investigator(Kenkyū-buntansha) |
MATSUOKA Hirofumi Fukuoka Univ., Sch. of Med., Instructor, 医学部, 講師 (50269007)
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| Project Period (FY) |
1993 – 1995
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| Keywords | Reflux nephropathy / Renal biopsy / Turning point to irreversible renal disease / Glomerular hypertrophy / Dopamine test |
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| Research Abstract |
To clarify the extent of renal damage and the turning point to progressivedisease in reflux nephropathy, open renal biopsy in non-scarred area wascarried out on 95 consecutive patients with more than grade 3 reflux or renal scarring on images.
In reflux nephropathy both interstitial and glomerular damages advances with an increase in the scarring grade even in macroscopically normal regions.
Of those changes, however, glomerular sclerosis and hypertrophy are rapidly accelerated between stages c-a, as shown by the combinated Smellie's scarring grade of the bilateral kidneys. These two steep histologic changes in stage c-a were followed by a remarkable reduction in renal function (DTPA-GFR) and an increase in the amount of urinary protein which suggest that hemodynamic change or overloading in the remnant nephrons starts in stage c-a. In this stage paremeters indicated 100mg/day of urinary protein, 70ml/ min of GFR (DTPA-GFR) and 2 S.D.of the extent of glomerular hypertrophy. which is expressed as the multiples of age-matched standard deviation of normal person. We followed up these cases for 3.7 years on average andthe kidney with scar b was led to scar c.
So, we revised the turning point to irreversible stage is the stage a/a, Other parameters were not neccesary to modify.
To see the renal reserve in reflux nephropathy dopamine (2-3mug/kg) test was performed. Results showed that GFR was maintained within 2S.D.of glomerukar hypertrophy but moved to decrease at further hypertrophyed stage and exhaused in the stage 4S.D.
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