運動,体位負荷腎クリアランス試験の設定とその意義

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  • Renal clearance tests in the exercise loading and the postural loading for a prediction of the activity of the glomerular losion of the glomerulonephritis
  • ウンドウ タイイ フカ ジン クリアランス シケン ノ セッテイ ト ソノ イ

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This study was attempted to predict the activity of the glomerular lesion of glomerulonephritis by the renal clearance tests in the exercise loading or the postural loading. The effects of the bicycle exercise (RMR=4.4) and the 2 hours' upright position on renal plasma flow (CPAH), glomerular filtration rate (Cthio, Ccr) and filtration fraction in healthy adults and patients with glomerulonephritis were studied. <BR>During the exercise loading or the postural loading, in healthy adults, CPAH significantly decreased, on the other hand Cthio (Ccr) slightly decreased. Consequently, the filtration fraction significantly increased. The increase in the filtration fraction is considered to be an adaptive response of the kidney to the loadings, especially the efferent arteriole, <BR>In patients with glomerulonephritis, Cthio (Ccr) significantly decreased as well as CPAH during the exercise loading or the postural loading. Consequently, the filtration fraction did not increase but sometimes decreased. These findings imply that an adaptive response of the kidney was lost in the glomerulonephritis, especially afferent arteriole. It was also found that the degree of the decrease in Cthio (Ccr) or the increase in the filtration fraction was well related to that of the activity of the glomerular lesion diagnosed by biopsy specimen. <BR>It was concluded practically that the measurement of Ccr during the 2 hours' standing load seemes to be sufficient to estimate the activity of the glomerular lesion of glomerulonephritisR Some factors affecting these results were also discussed.

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