Hypercalcemic nephropathy: chronic disease with predominant medullary inner stripe injury.
Hypercalcemic nephropathy: chronic disease with predominant medullary inner stripe injury.
复制标题
高钙血症肾病：以髓质内条纹损伤为主的慢性疾病。
DOI：
10.1038/ki.1990.87
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发表时间：
1990
影响因子：
19.6
通讯作者：
Brezis,M
中科院分区：
文献类型：
--
作者：
Rosen,S;Greenfeld,Z;Bernheim,J;Rathaus,M;Podjarny,E;Brezis,M
高钙血症肾病：以髓内条损伤为主的慢性疾病。由于最近在离体灌注的大鼠肾中观察到钙对髓质缺氧损伤的增强（Kidney Int 34：186-194，1988），因此在体内研究了慢性、长期高钙血症的肾形态。大鼠反复注射维生素D2（400，000单位/周）2至8周。血浆钙从2.1到2.8 mmol/L的慢性升高（P < 0.001）与最大尿渗透压的下降相关，而肾小球滤过率没有变化。最显著的形态学改变发生在外髓质的内条纹;这些变化的特征是一系列活动性损伤，随后破坏和萎缩的髓质粗升支，成纤维细胞和淋巴细胞浸润，和继发性扩张的集合管。髓射线也发生了类似的变化。这些变化伴随着增加肾脏前列腺素类的生产和急性肾功能衰竭的易感性消炎痛。由于其选择性发生在氧气供应最差的区域，这种内条损伤可能源于对缺氧的脆弱性，并可能在某些慢性肾病中发挥作用。
Hypercalcemie nephropathy: Chronic disease with predominant medullary inner stripe injury. Because of the recently observed augmentation of medullary hypoxic injury by calcium in isolated perfused rat kidneys (Kidney Int34:186–194, 1988), renal morphology of chronic, prolonged hypercalcemia was investigated in vivo. Rats were treated with repeated injections of vitamin D2(400,000 units/week) for two to eight weeks. Chronic elevation of plasma calcium from 2.1 to 2.8 mmol/liter (P < 0.001) was associated by a fall in maximal urine osmolality with no change in glomerular filtration rate. The most significant morphological alterations occurred in the inner stripe of the outer medulla; these changes were characterized by a sequence of active injury with subsequent destruction and atrophy of the medullary thick ascending limbs, fibroblastic and lymphocytic infiltration, and secondary dilatation of collecting ducts. Similar changes occurred in the medullary rays. These alterations were accompanied by increased renal prostanoid production and a predisposition to acute kidney failure from indomethacin. Because of its selective occurrence in zones of poorest oxygen supply, this inner stripe injury may derive from vulnerability to hypoxia and may play a role in some chronic nephropathies.