Renal Functional Reserve in Naïve HIV Patients

Pubblicato il Scarica PDF

Carlos G. Musso

DOI: 10.69097/41-04-2024-11

Carlos G. Musso1,2, Rossina Juarez3, Belloso W4, Henry Gonzalez-Torres2, Mercedes Capotondo4, Terrasa Sergio1, Fabrizio Cristiano5,6, Gustavo Aroca Martinez 2,7

1 Research Department, Hospital Italiano de Buenos Aires. Buenos Aires, Argentina
2 Facultad de Ciencias de la Salud. Universidad Simon Bolivar. Barranquilla, Colombia
3 Climedica Hospital. Buenos Aires, Argentina
4 Internal Medicine Department, Hospital Italiano de Buenos Aires. Buenos Aires, Argentina
5 UOSD Nefrologia Dialisi. Ospedale di Ortona. Contrada Santa Liberata. Asl 2 Lanciano Chieti. Italia
6 Department of Neuroscience, Imaging and Clinical Scienze, G. d´Annunzio. University of Chieti-Pescara. 66100 Chieti, Italia
7 Nephrology Division. Clínica de la Costa. Barranquilla, Colombia

Corresponding author:
Carlos Guido Musso
Research Department, Hospital Italiano de Buenos Aires. Buenos Aires, Argentina
Telephone: 005411 49590200
Gascón 450, Ciudad Autónoma de Buenos Aires, Argentina
E-mail: carlos.musso@hospitalitaliano.org.ar

 

Abstract

Introduction. Renal functional reserve (RFR) is the kidney capability of increasing its basal glomerular filtration rate (GFR) at least 20% after an adequate stimulus. Renal disorders have been reported in seropositive HIV patients, particularly the decrease in glomerular filtration rate (eGFR), nephrotic syndrome, and proximal tubular deficiency associated with the disease itself or the use of some anti-retroviral treatments. Thus, it was decided to carry out a prospective study in order to evaluate if RFR test was preserved in naive HIV patients.
Material and Method. GFR was measured by using cimetidine-aided creatinine clearance (CACC), and RFR as described Hellerstein et al. in seropositive naive HIV patients and healthy volunteers.
Results. RFR was evaluated in 12 naïve HIV patients who showed positive RFR (24.8±2%), but significantly lower compared to RFR in 9 control individuals (90.3 ± 5%).
Conclusion. In this study was found that renal functional reserve was positive in naïve HIV patients, but significantly lower compared to renal functional reserve achieved by seronegative healthy individuals.

Keywords: renal reserve, HIV, renal physiology

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Abbreviations

Renal Functional Reserve (RFR)
Glomerular Filtration Rate (GFR)
Human Immunodeficiency Virus (HIV)
Tenofovir Disoproxil-Fumarate (TDF)
Thick Ascending Limb of Henle’s Loop (TALH)
Tubular-Glomerular Feedback (TGF)
Cimetidine-Aided Creatinine Clearance (CACC)

 

Introduction                                                                                    

Renal functional reserve (RFR) is the renal capability of increasing its basal glomerular filtration rate (GFR) at least 20% after an adequate stimulus such as amino-acid infusion or oral protein overload. A positive renal reserve response requires the presence of both adequate glomerular and renal tubular function [1]. In order to evaluate GFR, one of the most simple and reliable method seems to be the cimetidine-aided creatinine clearance (CACC), particularly that which uses oral cimetidine supply. Since cimetidine inhibits creatinine secretion in the proximal tubules, the ratio of the CACC and GFR is about 1.1 [2–4]. 

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