Figure 222

Rates of progression in glomeruloneophritis. The decrease in glomeru lar filtration rate is illustrated. The rates of decline decreased considerably with administration of antihypertensive drug therapy. Among other mechanisms, the decrease in arterial pressure lowers transcapillary filtration pressures at the level of the glomerulus [20] This effect is correlated with a reduction in proteinuria and slower development of both glomerulosclerosis and interstitial fibrosis. A distinctive feature of many glomerular diseases is the massive pro-teinuria and nephron loss associated with high single-nephron glomerular filtration, partially attributable to afferent arteriolar vasodilation. The appearance of worsening proteinuria (>3 g/d) is related to progressive renal injury and development of renal failure. Reduction of arterial pressure can decrease urinary protein excretion and slow the progression of renal injury. Ccr—creatinine clearance rate; Cr-1/s—reciprocal creatinine, expressed as 1/creatinine. (From Bergstrom and coworkers [20]; with permission.)

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