Provoost A P, Van Aken M, Molenaar J C
Department of Pediatric Surgery, Erasmus University, Rotterdam, The Netherlands.
J Urol. 1991 Aug;146(2 ( Pt 2)):588-91. doi: 10.1016/s0022-5347(17)37863-1.
Animal models may be helpful to gain insight into the long-term functional outcome of the hydronephrotic kidney. Inbred Brown-Norway rats frequently have kidneys with a delayed urine outflow. In 26 male rats 99mtechnetium-diethylenetriaminepentaacetic acid (Tc-DTPA) furosemide renography was performed to assess the presence and degree of obstruction, and the contribution of each kidney to the total glomerular filtration rate. The total glomerular filtration rate was measured as the plasma clearance of 51chromium-ethylenediaminetetraacetic acid. The measurements were first done at the age of 3 months, and repeated at ages 6, 10 and 15 months. From the renography curve we derived an obstruction score ranging from 0 (minimum) to 10 (maximum) based on the time to peak, the 99mTc-DTPA accumulation at 15 minutes and the furosemide response. Kidneys were classified as normal, obstructed or equivocal. At the first renography 21 kidneys were normal, 8 were equivocal and 23 were obstructed. The total obstruction score of the next 3 renographies indicated that 29 units were normal, 14 were equivocal and 9 were obstructed. Two groups of rats with unilateral hydronephrosis (hydronephrotic kidney-1 and hydronephrotic kidney-2) were selected based on the total obstruction score of all 4 renographies. These groups were compared with rats with 2 normal kidneys. The hydronephrotic kidney-1 rats had an obstruction score indicating equivocal obstruction, while the obstruction score of the hydronephrotic kidney-2 rats indicated obstruction. During the 15 months of followup the presence of a unilateral hydronephrotic kidney with an obstruction score indicating obstruction did not affect the contribution of the hydronephrotic kidney to the total glomerular filtration rate, or the total glomerular filtration rate. We conclude that the obstruction score of a hydronephrotic kidney in rats may change considerably with time. In cases in which renography suggested the permanent presence of ureteral obstruction the glomerular filtration rate remained stable. Thus, renal functional criteria did not indicate obstruction. In Brown-Norway rats a hydronephrotic kidney is able to maintain a normal glomerular filtration rate during at least 50% of the normal lfie span.
动物模型可能有助于深入了解肾积水肾脏的长期功能结果。近交系棕色挪威大鼠经常出现尿液流出延迟的肾脏。对26只雄性大鼠进行了锝-二乙三胺五乙酸（Tc-DTPA）速尿肾图检查，以评估梗阻的存在和程度，以及每个肾脏对总肾小球滤过率的贡献。总肾小球滤过率通过51铬-乙二胺四乙酸的血浆清除率来测量。测量首先在3个月龄时进行，并在6、10和15个月龄时重复。从肾图曲线中，我们根据峰值时间、15分钟时的99mTc-DTPA积聚和速尿反应得出了一个梗阻评分，范围从0（最小）到10（最大）。肾脏被分类为正常、梗阻或不明确。在第一次肾图检查时，21个肾脏正常，8个不明确，23个梗阻。接下来3次肾图检查的总梗阻评分表明，29个单位正常，14个不明确，9个梗阻。根据所有4次肾图检查的总梗阻评分，选择了两组单侧肾积水大鼠（肾积水肾脏-1和肾积水肾脏-2）。将这些组与两只肾脏均正常的大鼠进行比较。肾积水肾脏-1组大鼠的梗阻评分表明为不明确梗阻，而肾积水肾脏-2组大鼠的梗阻评分表明为梗阻。在15个月的随访期间，存在梗阻评分表明为梗阻的单侧肾积水肾脏并不影响肾积水肾脏对总肾小球滤过率或总肾小球滤过率的贡献。我们得出结论，大鼠肾积水肾脏的梗阻评分可能会随时间发生相当大的变化。在肾图提示输尿管梗阻持续存在的情况下，肾小球滤过率保持稳定。因此，肾功能标准未表明存在梗阻。在棕色挪威大鼠中，肾积水肾脏能够在至少50%的正常寿命期间维持正常的肾小球滤过率。
