Adverse effects of growth in the glomerular microcirculation.

Compensatory renal and glomerular hypertrophy accompanies the many functional and structural changes associated with a reduction in functional renal mass. Increased levels of dietary sodium supplementation ranging from deficient to 2.3% Na+ (38-fold above the minimal daily requirement for the rat) in rats with subtotal nephrectomy were associated with a progressive rise in proteinuria and renal size without any significant change in arterial pressure. To further define these relationships, groups of rats on two intermediate levels of sodium intake were studied in detail. Single-nephron filtration rate and glomerular capillary pressure were similar in subtotally nephrectomized rats fed the 0.06 and 0.46% Na+ diets. Both the volume fraction and absolute volume of periodic acid-Schiff staining mesangial lesions in the glomerulus were greater in the 0.46% Na+ group. Glomerular volume and the mean glomerular capillary radius was larger in the 0.46% Na+ group. Increased glomerular tension, as predicted by the Laplace law, may represent a final common pathway by which compensatory growth and/or glomerular hypertension result in glomerular injury.