UNILATERAL NEPHRECTOMY AND PROGRESSION OF RENAL-FAILURE

Extensive ablation of renal mass in experimental animals leads to prog ressive glomerulosclerosis and chronic renal failure (CRF). Clinical s tudies are far from answering the question whether patients with reduc ed renal mass are at risk of developing progressive CRF. The aim of ou r study was to examine the morphological and functional aspects of the remnant kidney in a group of patients who underwent unilateral nephre ctomy for renal tuberculosis: 313 patients (161 M, 152 F) mean age 57. 2 +/- 10.7, were examined after a period ranging from 13.56 to 591.2 m onths. All patients were on ad libitum diet. Hypertension was found in 34.19% of the patients; SBP was 155.29 +/- 19.9 mm Hg and DBP was 92. 74 +/- 13.07 mm Hg. Estimation of renal size performed by ultrasound s canner gave the following results: length 116.78 +/- 8.99 mm; width 58 .24 +/- 7.21 mm; thickness 17.88 +/- 1.96 mm. Kidney function assessed by serum creatinine levels showed a mean level of 1.28 +/-0.53 mg%. F orty-two patients (13.41%) had serum levels >1.5 mg% but 18 of them ha d nonconcomitant systemic or renal involvement. Microalbuminuria deter mined by RIA assay was found in 50.5% of the patients. In our group of patients renal functional impairment was low and hyperfiltration expr essed as microalbuminuria does not appear to be a primary factor in th e progression of renal failure.