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抗高血压治疗对实验性慢性肾衰竭的影响。

Effect of antihypertensive therapy in experimental chronic renal failure.

作者信息

Wight J P, Bassett A H, Hutchesson A, Thurrell W, el Nahas A M

机构信息

Sheffield Kidney Institute, Northern General Hospital, UK.

出版信息

Miner Electrolyte Metab. 1991;17(6):362-8.

PMID:1823385
Abstract

In this study, the effect of the antihypertensive agents nifedipine (4.5 mg/day) and hydralazine (50-200 mg/l of drinking water) on the progression of chronic renal failure and scarring was evaluated in rats submitted to subtotal (5/6) nephrectomy (SNx). The effect of blood pressure reduction was studied in groups of rats fed either a medium-protein diet (24%) or high-protein diet (50%). SNx rats fed a high-protein diet had significantly higher levels of proteinuria and severer renal scarring at sacrifice (120 days after SNx). Nifedipine reduced proteinuria in SNx rats fed a high-protein diet. Both drugs significantly reduced systemic hypertension in SNx rats. Hydralazine and nifedipine also reduced hypertriglyceridaemia but had no effect on blood cholesterol levels. However, in spite of adequate control of systemic hypertension with the agents studied, the severity of renal scarring (glomerular sclerosis or tubulo-interstitial scarring) was not affected by treatment. We confirm that the control of systemic hypertension is not sufficient to prevent renal scarring in rats submitted to extensive renal ablation.

摘要

在本研究中,对接受次全(5/6)肾切除术(SNx)的大鼠,评估了降压药硝苯地平(4.5毫克/天)和肼屈嗪(50 - 200毫克/升饮用水)对慢性肾衰竭进展和瘢痕形成的影响。在喂食中等蛋白饮食(24%)或高蛋白饮食(50%)的大鼠组中研究了血压降低的效果。喂食高蛋白饮食的SNx大鼠在处死时(SNx后120天)蛋白尿水平显著更高,肾瘢痕形成更严重。硝苯地平降低了喂食高蛋白饮食的SNx大鼠的蛋白尿。两种药物均显著降低了SNx大鼠的全身性高血压。肼屈嗪和硝苯地平还降低了高甘油三酯血症,但对血胆固醇水平无影响。然而,尽管所研究的药物充分控制了全身性高血压,但肾瘢痕形成(肾小球硬化或肾小管间质瘢痕形成)的严重程度并未受到治疗的影响。我们证实,控制全身性高血压不足以预防接受广泛肾切除的大鼠的肾瘢痕形成。

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