Effect of renal denervatoin on the glomerular filtration rate [GFR] and tubular function

ABSTRACT

The renal nerves are the communicating link between the central nervous system [CNS] and the kidney, contributing importantly to homeostatic regulation, renal blood flow [RBF], glomerular filtration rate [GFR], renal tubular solute and water transport and hormonal release. In patho-physiological conditions, abnormal regulation of efferent nerve activity constitutes significantly to associated abnormalities of renal function which in turn are of importance in the pathogenesis of many diseases such as hypertension. Denervation is a method commonly used to study the role of renal nerves in the control of kidney function, also it is mandatory in cases of kidney transplantation and when using ganglion blockers. To study the effect of renal denervation on kidney function in dog, using unilateral renal Denervation and split urine collection model. The left kidney was denervated through an abdominal approach. Urine and blood samples were collected for six clearance periods [10 minutes each]. The following parameters were done Urine flow rate Uv [ml/min/m[2] surface area]. GFR [ml/min/m[2]] by inulin clearance method [C[1n]] Urinary excretion rate for Na[+], K[+], Cl[-l] [U[Na+] V, U[K+] V, U[cl-]. V for denervated [DNX] and innervated [INN] kidneys. Percentage fractional excretion of Na[+] [%FE[Na+] was also calculated for both kidneys. Marked diuresis, natriuresis, kaliuresis, chloresis and increased% FE Na[+] and GFR for the denervated [DNX] kidney were found as compared to the innervated [INN] control. Renal denervation results in marked diuresis and solute loss in the acute stage, therefore it is recommended to compensate for these losses especially in the early stages of renal Denervation whether surgical as in kidney transplantation or pharmacological as by delivering ganglion blockers or a-adrenoceptor inhibitors for patients with hypertension, otherwise grave water and electrolyte imbalances may occur