The correlation between renal functional reserve and serum uric acid and quality of life in chronic kidney disease stage I–III

L.M. Savytska


Background. In clinical practice the renal functional reserve can be an important tool to identify the early kidney functional damage, cure them and impact diseases prognosis. The aim of this article was to review the concept of renal functional reserve in its relation with serum uric acid level and the quality of life in chronic kidney disease stage I–III. Materials and methods. The study included twenty-two patients with chronic kidney disease stage I–III. We used the renal functional reserve test of Hozhenko A.I. adapted to ambulatory medical care services with measuring serum uric acid level before and after water-salt loading with 0.5% sodium chloride. We assessed the quality of life using the SF-36 questionnaire. Results. Functional renal reserve was preserved in 19 patients (87 %) and averaged 115 ± 54 %, decreased in 2 patients (9 %), average 5.7 ± 2.1 %, and was absent in 1 patient (4 %) and va­lued –41 %. The level of functional renal reserve correlated with serum uric acid level, measured an hour after the water-salt load (p = 0.60; p-level 0.018), and the ave­rage value of uric acid was determined over 4 years (p = 0.74; p-level 0.0015). The renal functional reserve related with the scales of physical functio­ning (p = 0.60; p-level 0.03), vital activity (p = 0.68; p-level 0.01) and mental health (p = 0.58; p-level 0.04) while examining health-related qua­lity of life. Conclusions. Our findings indicate that serum uric acid levels should be controlled in patients with high renal functional reserve.


renal functional reserve; uric acid; chronic kidney disease


Molitoris BA. Rethinking CKD Evaluation: Should We Be Quantifying Basal or Stimulated GFR to Maximize Precision and Sensitivity? American Journal of Kidney Diseases. 2017;69(5):675-683. doi: org/10.1053/j.ajkd.2016.11.028.

Ivanov DD. Renin-angiotensin system blockers and renal functional reserve. Is there a limit of renoprotection? Pochki. 2015;4(14):12-5 (In Russian). doi: 10.22141/2307-1257.

Ronco C, Chawla LS. Glomerular and tubular kidney stress test: new tools for a deeper evaluation of kidney function. Nephron. 2016;134(3):191-194. doi: 10.1159/000449235.

Sharma A, Mucino MJ, Ronco C. Renal functional reserve and renal recovery after acute kidney injury. Nephron Clinical Practice. 2014;127(1-4): 94-100. doi: 10.1159/000363721.

Thomas DM, Coles GA, Williams JD. What does the renal reserve mean? Kidney international. 1994;45(2):411–416. doi: 10.1038/ki.1994.53.

Barai S, Gambhir S, Prasad N, Sharma RK, Ora M. Functional renal reserve capacity in different stages of chronic kidney disease. Nephrology. 2010;15(3):350-3. doi: 10.1111/j.1440-1797.2010.01291.x.

Zuccala A, Gaggi R, Zucchelli A, Zucchelli P. Renal functional reserve in patients with a reduced number of functioning glomeruli. Clinical Nephrology. 1989;32(5):229-34. PMID: 2582648.

Krishna GG, Kapoor SC. Preservation of renal reserve in chronic renal disease. American journal of kidney diseases. 1991 Jan;17(1):18-24. PMID: 1986565. doi: 10.1016/S0272-6386(12)80244-7.

Samoni S, Nalesso F, Meola M, et al. Intra-parenchymal renal resistive index variation (IRRIV) describes renal functional reserve (RFR): pilot study in healthy volunteers. Frontiers in Physiology. 2016;7:286. doi: 10.3389/fphys.2016.00286.

Kobalava ZhD, Kotovskaja JuV, Moiseev VS. Arterial'naja gipertonija. Kljuchi k diagnostike i lecheniju. [Arterial hypertension. Keys to diagnosis and treatment]. Moscow: GEOTAR-Media; 2009. 864p. (In Russian).

Bosch JP, Saccaggi A, Lauer A, Ronco C, Belledonne M, Glabman S. Renal functional reserve in humans. Effect of protein intake on glomerular filtration rate. The American journal of medicine.1983;75:943-50. PMID: 6650549. doi: 10.1016/0002-9343(83)90873-2.

Bilo HJG, Schaap GH, Blaak E, Gans ROB, Oe PL, Donker AJM. Effects of chronic and acute protein administration on renal function in patients with chronic renal insufficiency. Nephron. 1989;53(3):181-187.

Hisnutdinova LA, Iaksudova AN, Salihov IG. The significance of functional renal reserve in chronic kidney disease. Kazanskij medicinskij zhurnal. 2009;(90)3:425-8. (In Russian).

Fliser D, Zeler M, Nowack R, Ritz E. Renal functional reserve in healthy elderly subjects. Journal of the American Society of Nephrology. 1993 Jan;3(7):1371-7. PMID:8439649.

Musso CG, Reynaldi J, Martinez B, Pierángelo A, Vilas M, Algranati L. Renal reserve in the oldest old. International urology and nephrology. 2011;43(1):253-56. doi: 10.1007/s11255-010-9769-9.

Sulikowska B, Johnson RJ, Wiechecka-Korenkiewicz J, et al. Dopamine-Induced Changes in Serum Erythropoietin and Creatinine Clearance Reflect Risk Factors for Progression of IgA Nephropathy. Journal of Investigative Medicine. 2015;63(6):811-5. doi: 10.1097/JIM.0000000000000214.

Rook M, Hofker HS, Van Son, WJ, Homan Van der Heide JJ, Ploeg RJ, Navis GJ. Predictive Capacity of Pre‐Donation GFR and Renal Reserve Capacity for Donor Renal Function After Living Kidney Donation. American journal of transplantation. 2006;6(7):1653-9. doi: 10.1111/j.1600-6143.2006.01359.x.

Fuhrman DY, Maier PS, Schwartz G.J. Rapid assessment of renal reserve in young adults by cystatin C. Scandinavian journal of clinical and laboratory investigation 2013;73(4): 265-8. doi: 10.3109/00365513.2013.765964.

Rodenbach KE, Fuhrman DY, Maier. PS, Schwartz GJ. Renal Response to a Protein Load in Healthy Young Adults as Determined by Iohexol Infusion Clearance, Cimetidine-Inhibited Creatinine Clearance, and Cystatin C Estimated Glomerular Filtration Rate. Journal of Renal Nutrition. 2017 Apr. pii: S1051-2276(17)30028-6. doi: 10.1053/j.jrn.2017.01.021.

Hozhenko AI, Kravchuk AV, Sirman VM, Nikitenko OP, Romaniv LV. Functional renal reserve: physiological value of renal reserve and substantiation of the method of its determination. Pochki. 2015;4(14):7-11. (In Ukrainian). doi: 10.22141/2307-1257.

Hozhenko AІ, Kravchuk AV, Nikitenko OP, Moskolenko OM, Sirman VM. Funktsіonal'nii nirkovii rezerv: Monografіia. [Renal functional reserve. Monograph]. Odesa: Feniks; 2015. 180 p. (In Ukrainian).

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