<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>1870-7203</journal-id>
<journal-title><![CDATA[Acta médica Grupo Ángeles]]></journal-title>
<abbrev-journal-title><![CDATA[Acta méd. Grupo Ángeles]]></abbrev-journal-title>
<issn>1870-7203</issn>
<publisher>
<publisher-name><![CDATA[Grupo Ángeles, Servicios de Salud]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S1870-72032022000200207</article-id>
<article-id pub-id-type="doi">10.35366/104291</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[La sabiduría del riñón III. La adaptación de la función renal a su daño progresivo. Hipótesis de la nefrona intacta]]></article-title>
<article-title xml:lang="en"><![CDATA[The wisdom of the kidney III. The adaptation of renal function to its progressive damage. The intact nephron hypothesis]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Peña Rodríguez]]></surname>
<given-names><![CDATA[José Carlos]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Centro Diagnóstico Angeles  ]]></institution>
<addr-line><![CDATA[CDMX ]]></addr-line>
<country>México</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>06</month>
<year>2022</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>06</month>
<year>2022</year>
</pub-date>
<volume>20</volume>
<numero>2</numero>
<fpage>207</fpage>
<lpage>217</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_arttext&amp;pid=S1870-72032022000200207&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_abstract&amp;pid=S1870-72032022000200207&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_pdf&amp;pid=S1870-72032022000200207&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen: En esta revisión se despliega la historia que condujo a la &#8220;hipótesis de la nefrona intacta&#8221;, que explica en parte la gran capacidad adaptativa del riñón, que aun con pérdida de más de 80% de su función, mantiene la homeostasis corporal y las manifestaciones clínicas en estos pacientes son mínimas o moderadas. Este ensayo se inicia con el análisis del artículo del eminente patólogo del riñón el Dr. Jean Oliver &#8220;When is the kidney not a kidney&#8221;, donde relata las grandes alteraciones anatómicas del riñón en diversas enfermedades renales, y concluye: &#8220;Es que no hay &#8220;riñón&#8221; ni estructural ni funcionalmente en la enfermedad renal crónica&#8221;. Posterior a este trabajo, aun con esta gran alteración anatómica y funcional, el Dr. Bricker y otros investigadores consideraban que en las formas habituales de daño renal crónico se conservaba un cierto orden en la nefronas formadoras de la orina. Con esta hipótesis en la mente estos investigadores iniciaron con métodos de depuración la medición de las funciones del riñón en diversos modelos: pacientes con daño unilateral del riñón, perros y ratas con un riñón intacto y el otro lesionado o el modelo de 5/6 de nefrectomía o con padecimientos inflamatorios del riñón como la nefritis de Heyman y otros modelos. Estos estudios permitieron al Dr. Neal Bricker y su grupo demostrar que las nefronas no afectadas permanecían intactas y determinaban la función del riñón al mantener en balance diversas funciones como la excreción de sodio, el metabolismo de calcio y fósforo a expensas de lo que se conoce como el &#8220;mecanismo del trueque&#8221;, los resultados de la excreción de hidrógeno y amonio que permitían mantener el equilibrio ácido básico, la excreción de potasio, la concentración de la orina y otras funciones. Todos estos estudios condujeron a la &#8220;hipótesis de la nefrona intacta&#8221; y a la razón de la gran capacidad adaptativa del riñón a la pérdida progresiva de su función.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract: In this article, we present and analyzed the Intact Nephron Hypothesis that explains in part the great capacity of the diseased kidney, that after the destruction of thousands of nephrons and the loss of more than 80% of the renal function, the adaptive changes of the renal function were sufficient to maintain the body homeostasis with mild clinical symptoms. This saga began with the paper published by the eminent pathologist Jean Oliver &#8220;When is the kidney not a kidney&#8221;. In this article, Dr. Oliver states: &#8220;The answer I will give in (this) question is, therefore, now apparent. There is no kidney, either structural or functional, in chronic kidney disease&#8221;. Even though the loss of structural homogeneity, necessarily destroys the functional homogeneity. Dr. Bricker and other investigators believe that in the usual forms of chronic renal failure, a basic orderliness is conserved in the urine-forming nephrons. They studied the renal function with clearance methods in different models of kidney lesions in humans and animals, such as unilateral renal disease with one intact kidney, 5/6 nephrectomy, and induced Heyman&#8217;s nephritis and other models. These studies demonstrated that the intact nephrons, maintained the sodium balance, the control of calcium and phosphorus equilibrium with the so-called &#8220;Trade-off hypothesis&#8221;. The excretion of hydrogen and ammonium to maintain the acid-base balance. The potassium excretion and the concentration mechanism of the urine and other functions. The results of all these investigations are derived from the &#8220;Intact Nephron hypothesis&#8221; that explains the great adaptive functional capacity of the kidney.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Hipótesis de la nefrona intacta]]></kwd>
<kwd lng="es"><![CDATA[hipótesis del trueque]]></kwd>
<kwd lng="es"><![CDATA[daño renal progresivo]]></kwd>
<kwd lng="es"><![CDATA[balance de sodio]]></kwd>
<kwd lng="es"><![CDATA[fósforo]]></kwd>
<kwd lng="en"><![CDATA[Intact Nephron hypothesis]]></kwd>
<kwd lng="en"><![CDATA[trade-off hypothesis]]></kwd>
<kwd lng="en"><![CDATA[progressive renal damage]]></kwd>
<kwd lng="en"><![CDATA[sodium balance]]></kwd>
<kwd lng="en"><![CDATA[phosphate]]></kwd>
</kwd-group>
</article-meta>
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<numero>1</numero>
<issue>1</issue>
<page-range>136-50</page-range></nlm-citation>
</ref>
</ref-list>
</back>
</article>
