Kobayashi Noriyoshi, Maeda Atsuko, Horikoshi Satoshi, Shirato Isao, Tomino Yasuhiko, Ise Michihito
Division of Nephrology, Department of Internal Medicine, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan.
Nephron. 2002 Jul;91(3):480-5. doi: 10.1159/000064291.
The aim of the present study was to determine if treatment with an oral adsorbent (AST-120, Kremezin) might decrease the urinary albumin excretion and serum indoxyl sulfate (s-IS), and prevent glomerular sclerosis in early-stage renal failure, i.e. 0.9-1.2 mg/dl of serum creatinine (s-Cr) and 60-95 mg/dl of blood urea nitrogen (BUN), in subtotal (3/4) nephrectomized rats. Levels of s-Cr and s-IS in the AST-120-treated rats were significantly lower than those in the untreated control rats. The AST-120-treated rats showed an increase of creatinine clearance. Urinary protein and indoxyl sulfate excretion in the AST-120-treated rats were also significantly lower than those in the untreated control rats. The ratio of glomerular tuft area to the area of Bowman's capsules (GT/BC) in the AST-120-treated rats was significantly lower than that in the untreated control rats. The degree of glomerular sclerosis and tubulointerstitial fibrosis in the AST-120-treated rats was significantly lower than that in the untreated control rats. Furthermore, there was a significant relationship among the degree of GT/BC, glomerular sclerosis, tubulointerstitial fibrosis and the levels of urinary protein excretion. It appears that AST-120 might decrease the accumulation of s-Cr and s-IS, and prevent glomerular sclerosis in early stage renal failure in the subtotal nephrectomized rats.
本研究的目的是确定口服吸附剂（AST-120，可利美净）治疗是否可能降低尿白蛋白排泄和血清硫酸吲哚酚（s-IS），并预防大鼠肾大部（3/4）切除术后早期肾衰竭（即血清肌酐（s-Cr）为0.9 - 1.2mg/dl和血尿素氮（BUN）为60 - 95mg/dl）时的肾小球硬化。AST-120治疗组大鼠的s-Cr和s-IS水平显著低于未治疗的对照组大鼠。AST-120治疗组大鼠的肌酐清除率有所增加。AST-120治疗组大鼠的尿蛋白和硫酸吲哚酚排泄也显著低于未治疗的对照组大鼠。AST-120治疗组大鼠的肾小球毛细血管丛面积与鲍曼囊面积之比（GT/BC）显著低于未治疗的对照组大鼠。AST-120治疗组大鼠的肾小球硬化和肾小管间质纤维化程度显著低于未治疗的对照组大鼠。此外，GT/BC程度、肾小球硬化、肾小管间质纤维化与尿蛋白排泄水平之间存在显著相关性。似乎AST-120可能减少s-Cr和s-IS的蓄积，并预防肾大部切除术后早期肾衰竭大鼠的肾小球硬化。
