Abstract
Changes in glomerular filtration rate (GFR), renal plasma flow (RPF) and mean arterial pressure (MAP) were measured in subjects with various levels of spinal cord lesion and thus with different degrees of supraspinal sympathetic vasomotor control. They were tested in supine and head-up tilt positions, and their results were compared with those of normal subjects. The responses of paraplegic subjects to head-up tilt were not significantly different from those of normal controls. On the other hand, in quadriplegics in the supine position, GFR and RPF were significantly lower. When tilted, MAP and RPF decreased significantly, but the fall in GFR was not significant. In all three groups, the GFR during head-up tilt was similar, indicating that in spite of the great loss of supraspinal sympathetic control, quadriplegic subjects apparently equally constrict their afferent and efferent renal arterioles during orthostatic stress and thus prevent excessive fall of GFR.
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