PRODUCTION AND METABOLIC-CLEARANCE OF CALCITRIOL IN ACUTE RENAL-FAILURE
PRODUCTION AND METABOLIC-CLEARANCE OF CALCITRIOL IN ACUTE RENAL-FAILURE
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DOI：
10.1038/ki.1988.30
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发表时间：
1988-02-01
影响因子：
19.6
通讯作者：
SIMPSON, RU
中科院分区：
文献类型：
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作者：
HSU, CH;PATEL, S;SIMPSON, RU
观察缺血性急性肾小管坏死（ATN）后第3天和第7天骨化三醇代谢清除率（MCR）和生成率（PR）。夹紧肾动脉3天后肌酐清除率降低（0.42±-）。0.03 ml/min/100 g, N = 6 in ATN vs.068 .+-。对照组为0.09,N = 7；P < 0.001)。血药浓度(24.1 .+-。（1.9 pg/ml）和骨化醇的PR(9.8 +-。0.91 ng/kg/d)，与假性对照大鼠相比，ATN大鼠在缺血损伤后3天，分别显著降低(76.6 .+-。7.3 pg/ml, 29.6 +-。3.3 ng /公斤/天;P < 0.01)。骨化三醇的mcr在两组间差异无统计学意义(0.28 .+-。0.02 ml/min/kg)和假对照大鼠(0.27 .+-。0.01)。缺血损伤后第7天，当ATN大鼠肌酐清除率恢复正常时，这些动物的PR和血浆骨化三醇浓度也恢复正常。为了研究尿毒症对骨化三醇代谢的影响，我们对大鼠重新输注尿24小时后骨化三醇的MCR和PR进行了测定。骨化三醇的PR显著降低（9.42 .+-）。1.21;与对照组相比，20.5±。2.9 ng/kg/day, P < 0.001)。由于骨化三醇PR的降低也伴随着骨化三醇MCR的降低，因此肾脏完好的尿毒症大鼠血浆骨化三醇浓度保持在正常范围内。我们认为骨化三醇的PR在ATN大鼠早期降低。轻度ATN大鼠的MCR虽未降低，但严重急性肾功能衰竭时可能降低。
Metabolic clearance rate (MCR) and production rate (PR) of calcitriol were studied three and seven days after ischemic acute tubular necrosis (ATN). Creatinine clearance was decreased three days after clamping the renal arteries (0.42 .+-. 0.03 ml/min/100 g, N = 6 in ATN vs.068 .+-. 0.09, N = 7 in sham controls; P < 0.001). Plasma concentrations (24.1 .+-. 1.9 pg/ml) and PR of calcitrol (9.8 .+-. 0.91 ng/kg/day) were significantly lower in ATN rats three days after ischemic insult when compared to sham control rats, respectively (76.6 .+-. 7.3 pg/ml, and 29.6 .+-. 3.3 ng/kg/day; both P < 0.01). The MCRs of calcitriol were not different between ATN (0.28 .+-. 0.02 ml/min/kg) and sham control rats (0.27 .+-. 0.01). By the seventh day after ischemic injury, when creatinine clearance of ATN rats returned to normal, both the PR and plasma concentrations of calcitriol also returned to normal values in these animals. In order to assess the effect of uremia on calcitriol metabolism, MCR and PR of calcitriol were measured in rats with reinfusion of their urines for 24 hours. The PR of calcitriol was significantly decreased (9.42 .+-. 1.21; vs. controls, 20.5 .+-. 2.9 ng/kg/day, P < 0.001) in uremic animals. Since decreased PR of calcitriol was also accompanied by decreased MCR of calcitriol, plasma concentrations of calcitriol of the uremic rats with intact kidneys remained within normal values. We conclude that the PR of calcitriol is decreased early in ATN rats. Although the MCR was not decreased in mild ATN rats, it may decrease in severe acute renal failure.