Whiteside C, Katz A, Cho C, Silverman M
Department of Medicine, University of Toronto, Ontario.
Clin Invest Med. 1990 Oct;13(5):279-86.
To elucidate the important features of early renal disease in the diabetic dog, renal capillary permselectivity and fractional mesangial expansion with and without unilateral nephrectomy (NX) were examined. Pancreatectomized mongrel dogs (N = 9) received 10-20 U Regular and NPH insulin daily. Weekly blood glucose monitoring, 300 +/- 75 mg/dl (means +/- SD). Three dogs without NX had serial open needle biopsies 6-23 months post-pancreatectomy, revealing significant glomerular basement membrane widening and mesangial expansion. Without NX, inulin clearance increased from 2.55 +/- 0.89 (pre-diabetes) to 4.30 +/- 0.70 ml/min/kg body weight (N = 4, means +/- SD, p less than 0.05), whereas albuminuria, measured by radioimmunoassay, remained unchanged 2.57 +/- 1.03 (pre-diabetes) to 2.83 +/- 1.63 micrograms/min/kg body weight up to 23 months post-pancreatectomy. To determine whether altered renal capillary permselectivity occurred despite normal albuminuria, glomerular charge and size selectivity was analysed with serial fractional anionic dextran (20-44 A Stokes Einstein Radius) clearances. Furthermore, peritubular capillary permselectivity was probed with anionic and neutral 3H-dextran (26 A) using the multiple indicator dilution method. Fractional anionic dextran clearances remained unchanged up to 23 months, as did peritubular capillary permselectivity. Five diabetic dogs were compared to non-diabetic dogs with (N = 4) and without (N = 10) NX. To identify whether angiotensin II converting enzyme inhibition modified glomerular function or morphology, 3 diabetic + NX dogs received Captopril (5 mg/kg/day). At one year, diabetes + NX had an additive effect on renal hypertrophy, although fractional mesangial expansion was not enhanced by NX. Albuminuria was unaffected by NX or Captopril.(ABSTRACT TRUNCATED AT 250 WORDS)
为阐明糖尿病犬早期肾脏疾病的重要特征,我们研究了有或无单侧肾切除(NX)情况下的肾毛细血管选择通透性和系膜分数扩张情况。胰腺切除的杂种犬(N = 9)每天接受10 - 20单位的正规胰岛素和中效胰岛素。每周监测血糖,平均值为300 +/- 75 mg/dl(平均值 +/- 标准差)。三只未行NX的犬在胰腺切除术后6 - 23个月接受了系列开放性针吸活检,结果显示肾小球基底膜明显增宽和系膜扩张。未行NX时,菊粉清除率从2.55 +/- 0.89(糖尿病前期)增加到4.30 +/- 0.70 ml/min/kg体重(N = 4,平均值 +/- 标准差,p < 0.05),而通过放射免疫测定的蛋白尿在胰腺切除术后长达23个月保持不变,从2.57 +/- 1.03(糖尿病前期)变为2.83 +/- 1.63微克/分钟/千克体重。为确定尽管蛋白尿正常但肾毛细血管选择通透性是否改变,我们用系列分数阴离子葡聚糖(20 - 44 A斯托克斯爱因斯坦半径)清除率分析了肾小球电荷和大小选择性。此外,用阴离子和中性3H - 葡聚糖(26 A)通过多指示剂稀释法检测了肾小管周围毛细血管选择通透性。分数阴离子葡聚糖清除率在长达23个月时保持不变,肾小管周围毛细血管选择通透性也是如此。将五只糖尿病犬与有(N = 4)和无(N = 10)NX的非糖尿病犬进行比较。为确定血管紧张素II转换酶抑制是否改变肾小球功能或形态,三只糖尿病 + NX犬接受了卡托普利(5 mg/kg/天)。一年时,糖尿病 + NX对肾肥大有累加效应,尽管NX并未增强系膜分数扩张。蛋白尿不受NX或卡托普利影响。(摘要截短至250字)