Zeier M, Schmid M, Nowack R, Zacharewics S, Hasslacher C, Ritz E
Department of Internal Medicine, University of Heidelberg, Germany.
Nephrol Dial Transplant. 1992;7(6):501-6.
We compared the glomerular filtration rate (GFR) response to amino acids in patients with glomerular disease and polycystic kidney disease. The GFR response to infusion of amino acids (75 g/12 h), of dopamine (2 micrograms/kg per min), or their combination was evaluated in nine healthy probands and in patients with two types of renal diseases at various degrees of renal function: 15 patients with ADPKD and 11 patients with glomerular disease (IgA glomerulonephritis or diabetic nephropathy). Steady-state inulin infusion technique was used. In healthy subjects amino acids increased median C(in) in response to amino acids was not found in glomerular disease. In contrast in most ADPKD patients median C(in) increased after amino acids (+6.0 ml/min; range -4 to +68), (P less than 0.05). The response to amino acids was not modified by dopamine. The results demonstrate that amino acid-induced acute changes of glomerular filtration differ in polycystic kidney disease compared with glomerular disease. These observations may have implications with respect to mechanisms of progression.
我们比较了肾小球疾病和多囊肾病患者对氨基酸的肾小球滤过率（GFR）反应。在9名健康受试者以及患有两种不同类型肾脏疾病且处于不同肾功能程度的患者中，评估了对输注氨基酸（75 g/12 h）、多巴胺（2微克/千克每分钟）或二者联合的GFR反应：15例常染色体显性多囊肾病（ADPKD）患者和11例肾小球疾病（IgA肾小球肾炎或糖尿病肾病）患者。采用稳态菊粉输注技术。在健康受试者中，氨基酸可增加平均Cin，但在肾小球疾病患者中未发现氨基酸引起的这种反应。相反，在大多数ADPKD患者中，氨基酸输注后平均Cin增加（+6.0毫升/分钟；范围为-4至+68），（P<0.05）。多巴胺未改变对氨基酸的反应。结果表明，与肾小球疾病相比，多囊肾病中氨基酸诱导的肾小球滤过急性变化有所不同。这些观察结果可能对疾病进展机制有影响。
