Adaptive hyperfiltration in the aging kidney after contralateral nephrectomy

Anjali Bhatt Saxena, Bryan D. Myers, Geraldine Derby, Kristina L. Blouch, Jieshi Yan, Bing Ho, Jane C. Tan*

*Corresponding author for this work

Research output: Contribution to journalArticle

38 Scopus citations

Abstract

We examined the magnitude of adaptive hyperfiltration in the remaining kidney of 16 aging (>57 yr) and 16 youthful (<55 yr) individuals who had undergone a contralateral nephrectomy. Healthy volunteers who were youthful (n = 143) or aging (n = 37) provided control values for the binephric condition. One-kidney glomerular filtration rate (GFR; +42%), renal plasma flow (+38%), plasma oncotic pressure (+2.8 mmHg), and mean arterial pressure (+7.0 mmHg) were all higher in youthful uninephric vs. binephric subjects. Corresponding excesses in aging uninephric vs. binephric subjects were by 38 and 36% and 1.4 and 14.0 mmHg, respectively. Modeling of these data revealed that an isolated increase in either the glomerular ultrafiltration coefficient (Kf) by 110% or in the transcapillary hydraulic pressure gradient (ΔP) by 7 mmHg, could account for the observed level of hyperfiltration in youthful uninephric subjects. Corresponding increases for aging uninephric subjects were 61% for Kf and 5 mmHg for ΔP. We conclude that the magnitude of adaptive hyperfiltration is similar in aging to that in youthful uninephric subjects, albeit at a lower absolute GFR level. Isolated increases in either Kf or ΔP or a combination of smaller increases in both can account for the hyperfiltration. Greater adaptive arterial hypertension in aging than youthful uninephric subjects raises the possibility of a disproportionate role for glomerular hypertension and ΔP elevation in aging compared with youthful uninephric subjects. Glomerular hypertension could exacerbate the sclerosing glomerulopathy of senescence and lead to renal insufficiency. We recommend that living donors of a kidney transplantation in or beyond the seventh decade be used with caution.

Original languageEnglish (US)
Pages (from-to)F629-F634
JournalAmerican Journal of Physiology - Renal Physiology
Volume291
Issue number3
DOIs
StatePublished - 2006

Keywords

  • Glomerular filtration
  • Living kidney donor
  • Uninephrectomy

ASJC Scopus subject areas

  • Physiology
  • Urology

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