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Review
. 2016 May 5;1(1):57-63.
doi: 10.1016/j.ekir.2016.04.005. eCollection 2016 May.

Renal Stress Testing in the Assessment of Kidney Disease

Lakhmir S Chawla  1   2 , Claudio Ronco  3   4
Affiliations
Review

Renal Stress Testing in the Assessment of Kidney Disease

Lakhmir S Chawla et al. Kidney Int Rep. .

Abstract

As part of human evolutionary development, many human organ systems have innate mechanisms to adapt to increased "work demand" or stress. This reserve capacity can be informative and is used commonly in cardiology to assess cardiac function (e.g., treadmill test). Similarly, the kidney possesses reserve capacity, which can be demonstrated in at least 2 of the following renal domains: glomerular and tubular. When appropriate stimulants are used, healthy patients with intact kidneys can significantly increase their glomerular filtration rate and their tubular secretion. This approach has been used to develop diagnostics for the assessment of renal function. This article reviews both glomerular and tubular kidney stress tests and their respective diagnostic utility.

Keywords: acute kidney injury; chronic kidney disease; furosemide stress test; glomerular filtration; kidney stress test; maximum GFR.

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Figures

Figure 1
Figure 1
Comparison of stressors in the heart and kidney. C-R, cardiorenal.
Figure 2
Figure 2
Relationship between glomerular filtration rate (GFR) and serum creatinine changes. RFR-G, renal functional reserve–glomerular.
Figure 3
Figure 3
Variation in baseline glomerular filtration rate (GFR).
Figure 4
Figure 4
Furosemide urinary response tests tubular integrity. TAL, thick ascending limb.
See this image and copyright information in PMC

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