Glomerular capillary wall function in human lupus nephritis

Stuart Friedman; Samuel Strober; Elizabeth H Field; Earl Silverman; Bryan D Myers

doi:10.1152/ajprenal.1984.246.5.F580

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Glomerular capillary wall function in human lupus nephritis

Journal article

Peer reviewed

Glomerular capillary wall function in human lupus nephritis

Stuart Friedman, Samuel Strober, Elizabeth H Field, Earl Silverman and Bryan D Myers

The American journal of physiology, Vol.246(5 Pt 2), pp.F580-F591

05/1984

DOI: 10.1152/ajprenal.1984.246.5.F580

PMID: 6720964

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Abstract

Eighteen patients with nephrotic-range proteinuria due to lupus nephritis were evaluated with a differential solute clearance technique. Renal plasma flow was similar to that in 17 healthy volunteer controls (506 +/- 75 vs. 503 +/- 32 ml/min, P = NS), while oncotic pressure in pre- and postglomerular plasma was depressed by 9.2 and 17.3 mmHg, respectively. These findings are consistent with elevation of net ultrafiltration pressure and suggest that glomerular hypofiltration (51 +/- 9 vs. 103 +/- 8 ml/min, P less than 0.001) was due to a lowered glomerular ultrafiltration coefficient (Kf). In lupus nephritis the fractional clearance of smaller dextrans (radii less than 50 A) was depressed, while that of larger dextrans (radii greater than 50 A) was elevated. A pore model of solute transport, when applied to the dextran filtration data, revealed a subpopulation of large protein-permeable pores in lupus nephritis not present in controls. Moreover, the fraction of glomerular filtrate permeating these enlarged pores correlated directly with the respective fractional clearances of albumin (r = 0.71) and immunoglobulin G (r = 0.75) in individual patients. Immunosuppression in nine patients was associated with an increase of the filtration rate and filtration fraction. Conversely, fractional protein clearances and the area fraction of the glomerular membrane occupied by large pores decreased. We conclude that human immune glomerular inflammation is manifested by a reduction of Kf and increased glomerular porosity and that these membrane alterations are partially reversible.

Immunosuppression

Glomerulonephritis - urine

Kidney Glomerulus - blood supply

Capillaries - physiopathology

Lupus Erythematosus, Systemic - complications

Glomerular Filtration Rate

Humans

Middle Aged

Male

Glomerulonephritis - complications

Kidney Glomerulus - pathology

Membranes - pathology

Glomerulonephritis - pathology

Adult

Female

Glomerulonephritis - physiopathology

Details

Title: Subtitle: Glomerular capillary wall function in human lupus nephritis
Creators: Stuart Friedman
Samuel Strober
Elizabeth H Field
Earl Silverman
Bryan D Myers
Resource Type: Journal article
Publication Details: The American journal of physiology, Vol.246(5 Pt 2), pp.F580-F591
DOI: 10.1152/ajprenal.1984.246.5.F580
PMID: 6720964
NLM abbreviation: Am J Physiol
ISSN: 0002-9513
eISSN: 2163-5773
Publisher: American Physiological Society
Grant note: AM-29985 / NIADDK NIH HHS AM-20610 / NIADDK NIH HHS
Language: English
Date published: 05/1984
Academic Unit: Immunology; Internal Medicine
Record Identifier: 9984094481902771

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