Reserva funcional renal em indivíduos obesos com e sem hipertensão

Introducao: Testes pos-ingestao proteica aguda tem sido utilizados para identificar a reserva funcional renal (RFR). Embora citadas as alteracoes hemodinâmicas como aumento da taxa de filtracao glomerular (TFG) e do fluxo plasmatico renal nos individuos obesos, poucos sao os estudos encontrados que enfocam a RFR deste grupo populacional. Objetivo: Avaliar a RFR dos individuos obesos com e sem hipertensao. Metodologia: Foram incluidos no estudo homens e mulheres dos 18 aos 50 anos, com funcao renal aparentemente normal, alocados em tres grupos: obesos, obesoshipertensos e voluntarios saudaveis. A TFG foi avaliada pela depuracao da creatinina corrigida por superficie corporea antes e apos 180min de uma ingestao lacteoproteica. Resultados: Foram estudados 35 obesos, 24 obesos hipertensos e 12 voluntarios saudaveis. Nao houve mudanca entre os valores da TFG quando comparados os periodos pre e pos-ingestao proteica nos obesos (105,8 x 09,7ml/min/1,73m2), obesos hipertensos (123,9 x110,9ml/min/1,73m2) e voluntarios normais (109,9 x 18,2ml/min/1,73m2). Individualmente, foram encontrados individuos respondedores ao teste (>10%de aumento na TFG): nove respondedores no grupo dos obesos, quatro nos obesos hipertensos e seis nos voluntarios normais. Conclusao: A ingestao de uma carga proteica aguda com lactoproteina nao aumentou a TFG nos grupos estudados, mas as respostas obtidas nao foram homogeneas. Introduction: Acute oral protein loading tests have been used to identify the renal function reserve (RFR). The hemodynamic alterations induced by protein intake are well described and include an increase of both, the glomerular filtration rate (GFR) and the plasmatic renal flow. However few are the studies that focus the RFR in obese individuals. Objective: To evaluate the RFR of the obese individuals with and without hypertension. Methodology: They had been enclosed in the study men and women from 18-50, with apparently normal renal function placed in three groups: obese, hypertensive obese and healthy volunteers. The glomerular filtration rate (GFR) was evaluated by the corrected creatinine clearance through the corporal surface before and after 180 min of the protein ingestion (casein). Results: 35 obese, 24 hypertensive obese and 12 healthy volunteers had been studied. It did not have a change between the GFR values when compared the pre and post-protein ingestion periods in the obese (105,8x 109,7 ml/min/1,73m2), hypertensive obese (123,9x 110,9ml/min/1,73m2) and normal volunteers (109,9 x 118,2ml/min/1,73m2). Individually, it had been found respondent individuals to the test (>10% of increase in the GFR); nine in the obese group, four in the hypertensive obese and six in the normal volunteers. Conclusion: The acute oral protein load did not consistently increase the GFR in the studied groups.