Early atherosclerosis aggravates the effect of renal artery stenosis on the swine kidney
Early atherosclerosis aggravates the effect of renal artery stenosis on the swine kidney
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DOI：
10.1152/ajprenal.00159.2010
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发表时间：
2010-07-01
影响因子：
4.2
通讯作者：
Lerman, Lilach O.
中科院分区：
文献类型：
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作者：
Urbieta-Caceres, Victor H.;Lavi, Ronit;Lerman, Lilach O.
Urbieta-Caceres VH，Lavi R，朱 XY，Crane JA，Textor SC，勒曼 A，勒曼 LO。早期动脉粥样硬化加剧了肾动脉狭窄对猪肾脏的影响。 Am J Physiol Renal Physiol 299：F135-F140，2010。首次发表于 2010 年 5 月 12 日； doi: 10.1152/ajprenal.00159.2010.-在终末期肾病患者中越来越多地发现动脉粥样硬化性肾动脉狭窄 (ARAS)。 ARAS 患者的肾功能恶化比非动脉粥样硬化性肾动脉狭窄 (RAS) 患者更频繁。本研究旨在检验动脉粥样硬化改变单肾血流动力学和功能与狭窄严重程度之间关系的假设。家猪的单侧 RAS 程度（4 只正常、26 只 RAS 和 22 只 ARAS）与在 ACh 内皮依赖性攻击前后通过 64 层多探测器计算机断层扫描评估的肾功能和血流动力学相关。 RAS 和 ARAS 的狭窄程度和平均动脉压增加相似。 RAS和ARAS中狭窄的单肾体积、血流量、肾小球滤过率和皮质灌注均低于正常值，但仅在RAS中与狭窄程度的增加呈负相关（分别为r = -0.62、r = -0.49、r = -0.51和r = -0.46，均P < 0.05）。仅在 ARAS 中，基底肾小管液体浓缩能力和狭窄皮质灌注反应对 ACh 均减弱。这项研究表明，动脉粥样硬化调节肾动脉狭窄对狭窄肾血流动力学、功能和肾小管动力学的影响。这些观察结果强调了致动脉粥样硬化因子对肾脏的直接肾内影响。
Urbieta-Caceres VH, Lavi R, Zhu XY, Crane JA, Textor SC, Lerman A, Lerman LO. Early atherosclerosis aggravates the effect of renal artery stenosis on the swine kidney. Am J Physiol Renal Physiol 299: F135-F140, 2010. First published May 12, 2010; doi: 10.1152/ajprenal.00159.2010.-Atherosclerotic renal artery stenosis (ARAS) is increasingly identified in patients with end-stage renal disease. Renal function in ARAS patients deteriorates more frequently than in nonatherosclerotic renal artery stenosis (RAS). This study was designed to test the hypothesis that atherosclerosis modifies the relationship between single-kidney hemodynamics and function and the severity of stenosis. The degree of unilateral RAS in domestic pigs (4 normal, 26 RAS, and 22 ARAS) was correlated with renal function and hemodynamics evaluated by 64-slice multidetector computerized tomography before and after endothelium-dependent challenge with ACh. The degree of stenosis and increase in mean arterial pressure were similar in RAS and ARAS. Stenotic single-kidney volume, blood flow, glomerular filtration rate, and cortical perfusion were lower than normal in both RAS and ARAS, but only in RAS correlated inversely with increasing degree of stenosis (r = -0.62, r = -0.49, r = -0.51, and r = -0.46, respectively, P < 0.05 for all). Basal tubular fluid concentration capacity and stenotic cortical perfusion response to ACh were both blunted only in ARAS. This study shows that atherosclerosis modulates the impact of a stenosis in the renal artery on stenotic kidney hemodynamics, function, and tubular dynamics. These observations underscore the direct intrarenal effect of atherogenic factors on the kidneys.