ω-3多不饱和脂肪酸12个月治疗对IgA肾病患者肾小球滤过对多巴胺反应的影响

Effect of 12-month therapy with omega-3 polyunsaturated acids on glomerular filtration response to dopamine in IgA nephropathy.

作者信息

Sulikowska Beata, Niewegłowski Tomasz, Manitius Jacek, Lysiak-Szydłowska Wiesława, Rutkowski Bolesław

机构信息

Department of Transplantation, Nephrology and Internal Medicine, Medical University of Gdańsk, Gdańsk, Poland.

出版信息

Am J Nephrol. 2004 Sep-Oct;24(5):474-82. doi: 10.1159/000080670. Epub 2004 Sep 1.

DOI:10.1159/000080670

PMID:15340256

Abstract

BACKGROUND

Omega-3 polyunsaturated acids therapy is efficient in primary IgA nephropathy. It is unknown whether doses of omega-3 smaller than those given previously are still effective. The aim of the study was to examine the effect of omega-3 therapy on renal vascular function in relation to proteinuria and urinary excretion of N-acetyl-beta-D-glucosaminidase (NAG).

METHODS

20 IgA patients aged 36.5 +/- 10.77 with creatinine clearance (Cr(cl)) 105.71 +/- 27.3 ml/min and proteinuria 3.31 +/- 2.01 g/24 h were given orally 810 mg EPA and 540 mg DHA daily for 12 months. Before and at the end of the study, 24-hour proteinuria, serum homocysteine, and Cr(cl) were measured. At the same time, renal vascular function was estimated as dopamine-induced glomerular filtration response (DIR). DIR was measured as: two 120-min lasting Cr(cl) (before and during 2 microg/kg b.w./min i.v. dopamine).

RESULTS

The results obtained during follow-up were as follows (baseline vs. after therapy): DIR 14.9 +/- 16.4 vs. 30.3 +/- 14.3% (p < 0.01); urine protein 2.31 +/- 2.01 vs. 1.31 +/- 1.37 g/24 h (p < 0.01); (Cr(cl)) 105.71 +/- 27.3 vs. 103.9 +/- 20.9 ml/min (n.s.); NAG 8.3 +/- 1.8 vs. 6.0 +/- 1.2 U/g(creat) (p < 0.01), and homocysteine 16.2 +/- 3.15 vs. 13.8 +/- 2.6 micromol/l (p < 0.05). The only correlation found was linear correlation between basal DIR and DIR change (r = -0.570; p < 0.010) and basal NAG (r = -0.460; p < 0.50).

CONCLUSIONS

Omega-3 supplementation is associated with the improvement of both renal vascular function and tubule function.

摘要

背景

ω-3多不饱和脂肪酸疗法对原发性IgA肾病有效。目前尚不清楚低于先前使用剂量的ω-3是否仍然有效。本研究的目的是探讨ω-3疗法对肾血管功能的影响及其与蛋白尿和N-乙酰-β-D-氨基葡萄糖苷酶（NAG）尿排泄的关系。

方法

20例年龄为36.5±10.77岁的IgA患者，肌酐清除率（Cr(cl)）为105.71±27.3 ml/min，蛋白尿为3.31±2.01 g/24 h，每天口服810 mg二十碳五烯酸（EPA）和540 mg二十二碳六烯酸（DHA），持续12个月。在研究开始前及结束时，测量24小时蛋白尿、血清同型半胱氨酸和Cr(cl)。同时，通过多巴胺诱导的肾小球滤过反应（DIR）评估肾血管功能。DIR的测量方法为：两次持续120分钟的Cr(cl)测量（静脉注射多巴胺，剂量为2μg/kg体重/分钟，分别在注射前及注射期间测量）。

结果

随访期间获得的结果如下（基线值与治疗后值）：DIR为14.9±16.4 vs. 30.3±14.3%（p<0.01）；尿蛋白为2.31±2.01 vs. 1.31±1.37 g/24 h（p<0.01）；（Cr(cl)）为105.71±27.3 vs. 103.9±20.9 ml/min（无显著差异）；NAG为8.3±1.8 vs. 6.0±1.2 U/g(肌酐)（p<0.01），同型半胱氨酸为16.2±3.15 vs. 13.8±2.6 μmol/l（p<0.05）。唯一发现的相关性是基础DIR与DIR变化之间的线性相关性（r=-0.570；p<0.010）以及基础NAG与DIR变化之间的线性相关性（r=-0.460；p<0.50）。