Wooldridge J D, Gregory C R
Veterinary Medical Teaching Hospital, Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, USA.
Vet Surg. 1999 Jan-Feb;28(1):31-7. doi: 10.1053/jvet.1999.0031.
To measure the blood concentrations of total and ionized serum magnesium in feline renal transplant recipients and to determine if there was a correlation between these concentrations and the development of neurological disorders after renal transplantation.
Prospective clinical study.
Fourteen client-owned cats undergoing renal transplantation as a treatment for renal failure. Ten healthy adult cats were used to establish normal electrolyte concentrations.
Total and ionized serum magnesium as well as potassium and ionized calcium concentrations were measured in 14 renal transplant recipients at five intervals: preoperatively; immediately postoperatively; and 24, 48, and 120 hours postoperatively. The mean values from all 14 cats over each time interval were compared with the normal range. The serum concentration of these electrolytes, particularly magnesium, was evaluated in relation to the occurrence of neurological complications.
Ninety-four percent of all ionized serum magnesium concentrations measured in clinical patients were below normal. Ninety percent of all total serum magnesium concentrations were within the normal range, and no cats had abnormally low total serum magnesium concentrations at any time. All clinical patients were hypocalcemic at all intervals. Sixty-six percent of all serum potassium concentrations were below normal. One cat in the study group experienced neurological problems, including seizures, in the immediate postoperative period. The signs appeared to be related to hypertension and responded to appropriate therapy. All electrolyte concentrations in this cat, including ionized magnesium, were within the same range of values as other clinical patients.
Ionized serum magnesium concentrations are decreased in feline renal transplant recipients in the perioperative period; however, hypomagnesemia would not appear to be directly related to the development of neurological disorders. None of the study patients were hypomagnesemic when total serum magnesium concentrations were measured over the same intervals. In addition, ionized serum calcium concentrations and serum potassium concentrations are below normal in the perioperative period.
The specific clinical significance of these abnormalities is unknown. It is possible that the profound weakness and depression that is commonly seen in feline renal transplant recipients in the immediate postoperative period may be improved by supplementation with these electrolytes. Further work is needed to understand the implications of these abnormalities.
测定猫肾移植受者血清总镁和离子化镁的血药浓度，并确定这些浓度与肾移植后神经功能障碍的发生之间是否存在相关性。
前瞻性临床研究。
14只接受肾移植治疗肾衰竭的客户拥有的猫。使用10只健康成年猫来确定正常电解质浓度。
在14只肾移植受者中，于五个时间点测量血清总镁、离子化镁以及钾和离子化钙的浓度：术前；术后即刻；术后24、48和120小时。将所有14只猫在每个时间间隔的平均值与正常范围进行比较。评估这些电解质，尤其是镁的血清浓度与神经并发症发生情况的关系。
临床患者中测得的所有离子化血清镁浓度的94%低于正常水平。所有血清总镁浓度的90%在正常范围内，且在任何时候都没有猫的血清总镁浓度异常低。所有临床患者在所有时间点均为低钙血症。所有血清钾浓度的66%低于正常水平。研究组中的一只猫在术后即刻出现了包括癫痫发作在内的神经问题。这些症状似乎与高血压有关，并对适当的治疗有反应。这只猫的所有电解质浓度，包括离子化镁，与其他临床患者的值在同一范围内。
猫肾移植受者围手术期离子化血清镁浓度降低；然而，低镁血症似乎与神经功能障碍的发生没有直接关系。在相同时间间隔测量血清总镁浓度时，没有研究患者出现低镁血症。此外，围手术期离子化血清钙浓度和血清钾浓度低于正常水平。
这些异常的具体临床意义尚不清楚。术后即刻猫肾移植受者中常见的严重虚弱和抑郁可能通过补充这些电解质得到改善。需要进一步的研究来了解这些异常的影响。
