Early atherosclerosis aggravates renal microvascular loss and fibrosis in swine renal artery stenosis.
Early atherosclerosis aggravates renal microvascular loss and fibrosis in swine renal artery stenosis.
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DOI：
10.1016/j.jash.2016.01.019
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发表时间：
2016-04
期刊：
影响因子：
--
通讯作者：
Lerman LO
中科院分区：
文献类型：
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作者：
Sun D;Eirin A;Ebrahimi B;Textor SC;Lerman A;Lerman LO
动脉粥样硬化和肾动脉狭窄（ARAS）患者的肾功能恶化比非动脉粥样硬化RAS患者更频繁。我们假设与RAS相比，ARAS可加重狭窄性肾脏微血管损失。将家猪随机分为正常、RAS和ARAS（RAS饲喂高胆固醇饲料）组（每组n=7）。10周后，在体内评价狭窄肾氧合、肾血流量（RBF）和肾小球滤过率（GFR），并通过Micro-CT评价微血管密度。RAS和ARAS的血压升高，狭窄肾的RBF和GFR同样降低。RAS降低了小尺寸皮质微血管（<200 µm）的密度，而ARAS将降低范围扩大到中等尺寸微血管（200-300 µm）。皮质缺氧和间质纤维化在RAS和ARAS中均增加，但仅在RAS中与微血管密度呈负相关。动脉粥样硬化导致肾脏微血管的损失，但其他决定因素可能有助于猪ARAS中的皮质缺氧和纤维化。
Renal function in patients with atherosclerosis and renal artery stenosis (ARAS) deteriorates more frequently than in non-atherosclerotic RAS. We hypothesized that ARAS aggravates stenotic kidney microvascular loss compared to RAS. Domestic pigs were randomized to Normal, RAS, and ARAS (RAS fed a high-cholesterol diet) groups (n=7 each). Ten weeks later stenotic kidney oxygenation, renal blood flow (RBF), and glomerular filtration rate (GFR) were evaluated in-vivo, and microvascular density by Micro-CT. Blood pressure in both RAS and ARAS was elevated, and stenotic kidney RBF and GFR similarly decreased. RAS decreased the density of small-size cortical microvessels (<200 µm), while ARAS extended the decrease to medium-sized microvessels (200–300 µm). Cortical hypoxia and interstitial fibrosis increased in both RAS and ARAS, but correlated inversely with microvascular density only in RAS. Atherosclerosis aggravates loss of stenotic-kidney microvessels, yet additional determinants likely contribute to cortical hypoxia and fibrosis in swine ARAS.