Neuroendocrinology of chronic renal failure and renal transplantation.
Neuroendocrinology of chronic renal failure and renal transplantation.
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慢性肾功能衰竭和肾移植的神经内分泌学。
DOI：
10.1097/00007890-199111000-00012
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发表时间：
1991
期刊：
影响因子：
6.2
通讯作者：
Brown,MR
中科院分区：
文献类型：
--
作者：
Crum,R;Fairchild,R;Bronsther,O;Dominic,W;Ward,D;Fernandez,R;Brown,MR
将正常受试者的神经内分泌活动与慢性肾功能衰竭维持性血液透析（CRF-HD）患者和接受环孢素治疗的肾移植（RT）受者进行比较，以进一步确定其相关液体、电解质和血流动力学异常的机制。为评价CRF和RT患者的神经内分泌功能，测定了HD和RT前后血浆血管紧张素II（A-II）、血管加压素（AVP）、心钠素（ANP）、神经肽Y（NPY）、肾上腺素（E）和去甲肾上腺素（NE）的水平。HD未引起AVP、ANP、NPY、E或NE血浆浓度的显著变化。NE血浆水平，但不是E水平，增加前和后HD。A-II血浆水平在CRF患者中基础升高，在HD后显著升高。RT后，血浆A-II、AVP、NPY和肌酐水平在第一周显著下降，但AVP和NPY未恢复正常。RT患者血浆ANP水平在第一个月内升高，然后下降至正常水平。RT前后NE水平均升高，但E水平未升高。尽管进行了降压治疗，但RT后组平均动脉压在POD 6时从100+/-4.4 mmHg升高至116+/-3.7 mmHg。
Neuroendocrine activity in normal subjects was compared to patients with chronic renal failure on maintenance hemodialysis (CRF-HD) and to cyclosporinetreated renal transplantation (RT) recipients in an effort to further define the mechanisms underlying their associated fluid, electrolyte, and hemodynamic abnormalities. To evaluate neuroendocrine function in CRF and RT patients, plasma levels of angiotensin II (A-II), vasopressin (AVP), atrial natriuretic peptide (ANP), neuropeptide Y, neuropeptide Y (NPY), epinephrine (E), and norepinephrine (NE) were measured before and after HD and RT. Plasma concentrations of A-II, AVP, ANP, and NPY were significantly elevated in patients with CRF. HD did not produce a significant change in plasma concentrations of AVP, ANP, NPY, E, or NE. NE plasma levels, but not E levels, increased pre-and post-HD. A-II plasma levels were elevated basally in CRF patients and significantly increased following HD. Following RT, plasma levels of A-II, AVP, NPY, and creatinine decreased significantly over the first week, but AVP and NPY did not normalize. Plasma levels of ANP were elevated during the first month, then decreased to normal levels in RT patients. NE levels, but not E levels, were elevated both pre-and post-RT. Despite antihypertensive treatment, the group mean arterial pressure increased post-RT from 100+/-4.4 to 116+/-3.7 mmHg by POD 6.