ACID‐BASE IN RENAL FAILURE: Twice‐Told Tales of Metabolic Acidosis, Glucocorticoids, and Protein Wasting: What Do Results from Rats Tell Us About Patients with Kidney Disease?
ACID‐BASE IN RENAL FAILURE: Twice‐Told Tales of Metabolic Acidosis, Glucocorticoids, and Protein Wasting: What Do Results from Rats Tell Us About Patients with Kidney Disease?
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肾衰竭中的酸碱：代谢性酸中毒、糖皮质激素和蛋白质浪费的双重故事：大鼠的结果告诉我们有关肾病患者的哪些信息？
作者：
J. Bailey;W. Mitch
从慢性肾衰竭的动物研究中已经学到了很多与临床研究密切相关的东西，因为动物模型与人类反应相似。这些研究证实，纠正代谢性酸中毒对蛋白质代谢、氮平衡和生长具有有利的影响。在存在代谢性酸中毒的情况下，尿毒症患者的钙离子增多。糖皮质激素参与加速肌肉中的蛋白质降解，这导致瘦体重的损失，而低胰岛素水平似乎在加速增加的catabolism中起允许的作用。介导这些变化的细胞机制包括肌肉中泛素-蛋白酶体途径和支链酮酸脱氢酶活性的上调。大鼠研究中的许多发现已在人体研究中得到证实，并具有重要的临床意义，因为纠正代谢性酸中毒可改善营养状况，并减弱相关的蛋白质代谢增加。
Much has been learned from animal studies in chronic renal failure that is germane to clinical studies because animal models parallel human responses. Such studies have affirmed that correction of metabolic acidosis has a favorable effect on protein metabolism, nitrogen balance and growth. In the presence of metabolic acidosis, catabolism is increased in uremia. Glucocorticoids are involved in accelerating protein degradation in muscle, which results in loss of lean body mass, while a low insulin level appears to play a permissive role in accelerating increased catabolism. Cellular mechanisms mediating these changes include upregulation of the ubiquitin‐proteasome pathway and branched‐chain ketoacid dehydrogenase enzyme activity in muscle. Many of these findings from rat studies have been confirmed in human studies and have important clinical implications because correction of metabolic acidosis improves nutritional status and blunts the associated increase in protein catabolism.
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DOI：
10.1152/ajpcell.1999.276.5.c1132
发表时间：
1999-05-01
影响因子：
5.5
作者：
Mitch, WE;Bailey, JL;Price, SR
通讯作者：
Price, SR
代谢性酸中毒中支链α-酮酸脱氢酶活性的组织特异性反应。
DOI：
10.1681/asn.v9101892
发表时间：
1998
期刊：
Journal of the American Society of Nephrology : JASN
影响因子：
--
作者：
Price,SR;Wang,X;Bailey,JL
通讯作者：
Bailey,JL
影响因子：
15.9
作者：
Price, SR;Bailey, JL;Mitch, WE
通讯作者：
Mitch, WE
影响因子：
15.9
作者：
Lecker, SH;Solomon, V;Goldberg, AL
通讯作者：
Goldberg, AL
慢性代谢性酸中毒会加速清醒大鼠的全身蛋白水解和氧化。
影响因子：
19.6
作者：
May,RC;Masud,T;Logue,B;Bailey,J;England,B
通讯作者：
England,B