Padillo F J, Cruz A, Espejo I, Barcos M, Gómez-Alvarez M, Muntané J
Department of General Surgery, Reina Sofía University Hospital, Córdoba, Spain.
Rev Esp Enferm Dig. 2009 Jun;101(6):408-12. doi: 10.4321/s1130-01082009000600006.
The alteration of hormones regulating sodium and water status is related to renal failure in obstructive jaundice (OJ).
OJ was induced by common bile duct ligation. Samples were obtained from the control (SO) and OJ groups at 24 and 72 hours, and at 7 days. Different parameters related to biliary obstruction, liver and renal injury, and vasoactive mediators such as renin, aldosterone, endothelin-1 (ET-1) and prostaglandin E2 (PGE2) were studied.
Bile duct ligation caused an increase in total bilirubin (p < 0.001) and alkaline phosphatase (AP) (p < 0.001). The SO and OJ groups had the same values for diuresis, renin, and creatinine clearance at 24 h. However, animals with OJ had a lower sodium concentration in urine than SO animals (p < 0.01), as well as an increase in aldosterone levels (p < 0.03). ANP levels were moderately increased during OJ but did not reach statistical significance when compared to the SO group. In contrast, OJ animals showed a rise in serum ET-1 concentration (p < 0.001) and increased PGE2 in urine (p < 0.001).
Biliary obstruction induced an increase in ET-1 release and PGE2 urine excretion. These hormones might play a role during the renal complications associated with renal disturbances that occur during OJ.
调节钠和水状态的激素变化与梗阻性黄疸(OJ)中的肾衰竭有关。
通过胆总管结扎诱导OJ。在24小时、72小时和7天时从对照组(SO)和OJ组获取样本。研究了与胆道梗阻、肝和肾损伤以及血管活性介质如肾素、醛固酮、内皮素-1(ET-1)和前列腺素E2(PGE2)相关的不同参数。
胆管结扎导致总胆红素(p < 0.001)和碱性磷酸酶(AP)(p < 0.001)升高。SO组和OJ组在24小时时的利尿、肾素和肌酐清除率值相同。然而,OJ动物的尿钠浓度低于SO动物(p < 0.01),醛固酮水平也升高(p < 0.03)。OJ期间心房利钠肽(ANP)水平适度升高,但与SO组相比未达到统计学显著性。相反,OJ动物的血清ET-1浓度升高(p < 0.001),尿中PGE2增加(p < 0.001)。
胆道梗阻导致ET-1释放增加和PGE2尿排泄增加。这些激素可能在与OJ期间发生的肾脏紊乱相关的肾脏并发症中起作用。