FUNCTIONAL RESERVE CAPACITY IN PATIENTS W ITH IGA GLOMERULOPATHY

Protein loading is known to increase renal blood flow without influenc ing heart rate or systemic blood pressure. In 24 patients with IgA nep hropathy glomerular filtration rate, effective renal plasma flow and u rinary albumin excretion were examined before and after an acute prote in load. An increase in GFR was only observed in patients with a basel ine GFR > 75 ml/min/1.73 m2. Sixteen hypertensive patients were reeval uated after 4 weeks treatment with either perindopril or nifedipine. S ystolic and diastolic blood pressure were lowered in these patients. B oth drugs did not affect the glomerular response to acute protein load ing. We conclude that protein loading induces glomerular hyperfiltrati on in patients with IgA-nephropathy as long as GFR is above 75 ml/min. Treatment with perindopril or nifedipine in patients with IgA glomeru lopathy did not impair GFR and did not alter the hemodynamic response to amino acid loading.