Glomerular endothelial dysfunction determines disease progression: a hypothesis

American Journal of Nephrology
Prasit FutrakulNarisa Futrakul

Abstract

A glomerular endothelial function with its hemodynamic impact is proposed to determine disease progression. In the clinical settings associated with an intact endothelial function, such as minimal-change steroid-sensitive nephrosis, the early phase of diabetes mellitus and the early stage of an experimental model of renal ablation in animals, it was observed that adequate renal perfusion correlates with the intact structure and function of the nephron with no evidence of disease progression. In contrast, the clinical settings associated with endothelial dysfunction, such as chronic glomerulonephropathy, the late stage of diabetes mellitus and a renal ablation model in animals, are usually associated with a reduction in renal perfusion. The magnitude of renal hypoperfusion observed in all forms of chronic glomerulonephropathies is proportional to the degree of clinical severity. A progressive pattern of renal hypoperfusion is uniquely observed when disease severity progresses. In this context, a new therapeutic maneuver aiming to improve renal perfusion is proposed for treating glomerulonephropathy with disease progression and preventing it from developing to end-stage renal disease.

Citations

Apr 1, 1994·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·P Futrakul, N Futrakul
Apr 23, 1999·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·P FutrakulP Pongsin
Oct 21, 2011·Renal Failure·Narisa Futrakul, Prasit Futrakul
Feb 27, 2008·Renal Failure·Narisa FutrakulKavi Ratanabanangkoon
Dec 10, 1999·Renal Failure·E N Wardle
Sep 10, 2004·Renal Failure·Narisa FutrakulPrasit Futrakul
Sep 10, 2004·Renal Failure·Narisa FutrakulPrasong Siriviriyakul

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