Intact nephron hypothesis

The homeostasis afforded by the kidneys is affected by catecholamines, prostaglandins, renin, antidiuretic hormone, natriuretic hormone, and the number of functioning nephrons. The intact nephron hypothesis described by Bricker," which was first published more than 30 years ago, proposes that kidney function of patients with renal disease is the net result of a reduced number of appropriately functioning nephrons. As the number of nephrons is reduced from the initial complement of 2 million, those that are unaffected compensate for those that are damaged by disease or toxic... 

What is the intact nephron hypothesis, and how does it apply to dosage determinations in patients with renal dysfunction ... 

Chronic renal failure almost always is caused by intrinsic renal diseases and is characterized by slow, progressive development. Unlike the acute condition, chronic renal impairment generally is irreversible. The degree or loss of kidney functional capacity in the chronic condition is best described in terms of the intact nephron hypothesis, in which the diseased kidney is comprised of nephrons that are essentially nonfunctional because of pathologic conditions together with normal nephrons. Progressive renal impairment is the result of an increasing fraction of nonfunctional nephrons. 

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