Dobyan D C, Bulger R E, Eknoyan G
Department of Medicine, Renal Section, Baylor College of Medicine, Houston, Tex.
Miner Electrolyte Metab. 1991;17(2):112-5.
Alterations in the balance of several cations have been shown to affect the severity of acute renal failure. It has been suggested in both clinical and experimental studies that changes in phosphate balance can markedly potentiate as well as ameliorate the renal dysfunction seen in both acute and chronic nephropathies. To determine the role phosphate plays in the course of gentamicin-induced acute renal failure, we examined rats maintained on control, phosphate-supplemented, and phosphate-depleted diets. In both control and phosphate-supplemented groups of rats, the degree and severity of gentamicin-induced acute renal failure was similar. By contrast, renal function was better preserved in the phosphate-depleted group. Furthermore, morphologic evaluation revealed a significantly lower number of necrotic proximal tubule cells in phosphate-depleted rats when compared to the control or phosphate-replete rats. Renal cortical gentamicin concentrations were not different between the phosphate-depleted and phosphate-supplemented groups. We conclude that phosphate depletion is protective against nephrotoxicity. This effect appears to be independent of alterations in serum calcium, urinary calcium excretion and renal cortical gentamicin concentration.
多种阳离子平衡的改变已被证明会影响急性肾衰竭的严重程度。临床和实验研究均表明，磷酸盐平衡的变化既能显著加重也能改善急慢性肾病中的肾功能障碍。为了确定磷酸盐在庆大霉素诱导的急性肾衰竭过程中所起的作用，我们对分别维持在对照饮食、补充磷酸盐饮食和低磷饮食的大鼠进行了研究。在对照和补充磷酸盐的大鼠组中，庆大霉素诱导的急性肾衰竭的程度和严重性相似。相比之下，低磷组的肾功能得到了更好的保留。此外，形态学评估显示，与对照或补充磷酸盐的大鼠相比，低磷大鼠中坏死的近端肾小管细胞数量显著减少。低磷组和补充磷酸盐组之间肾皮质庆大霉素浓度没有差异。我们得出结论，低磷可预防肾毒性。这种作用似乎与血清钙、尿钙排泄和肾皮质庆大霉素浓度的改变无关。
