Title:
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Mechanisms of progression in chronic nephritis
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The aim of this thesis was to explore some of the factors involved
in the progression of chronic renal failure in experimental animals
and in man. Dietary manipulations were used to indirectly explore
some of the mechanisms of such progression to chronic renal
failure.
In rats, using a new experimental approach, I found that the
progression to chronic renal failure (CRF) of the immune mediated
nephrotoxic nephritis (NTN) depended on the degree of renal damage
or compensatory changes during the sub-acute stage of the disease.
The role of the host humoral immunity had little effect on such
progression,
In this model as well as in the sub-total nephrectomy model a low
protein diet (LPD) prevented severe renal failure and protected
against glomerulosclerosis. In NTN, a high protein diet (HPD)
similarly provided some protection although through the prevention
of renal tubulo—interstitial calcification and destruction. Such
a beneficial effect was not reproduced by a urea induced osmotic
diuresis or a DOCA and salt plasma volume expansion.
In man, a low protein diet slowed the rate of decline of patients
with CRF, However the LPD beneficial effect was selective with a
preferential action in patients with chronic tubulo-interstitial
diseases.
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