Sabbatini M, De Nicola L, Uccello F, Russo D, Conte G, Dal Canton A, Andreucci V E
Department of Nephrology, 2nd Faculty of Medicine, University of Naples, Italy.
Nephrol Dial Transplant. 1990;5(1):69-74. doi: 10.1093/ndt/5.1.69.
No study has, to our knowledge, evaluated the acute effects of low immunosuppressive doses of cyclosporin (CsA) on renal function. To establish whether a relationship exists between the dosage of CsA and the onset of nephrotoxicity, 28 rats were studied by renal clearances before (control) and after i.v. administration of different doses of CsA: 3 mg/kg b.w. (group 1); 7 mg/kg b.w. (group 2); 11 mg/kg b.w. (group 3); 15 mg/kg b.w. (group 4). No change in renal function was observed between control and the post-CsA period in groups 1 and 2. GFR (inulin clearance) was decreased vs the control period in group 3 and group 4 (-22% and -37%, respectively, P less than 0.001); the difference between these two groups was statistically significant (P less than 0.01). Effective renal plasma flow (PAH clearance) was similarly decreased in groups 3 and 4 vs their control periods (-21% and -28%, respectively, P less than 0.001) due to the increase of total renal vascular resistance (+41% and +42%, respectively, P less than 0.001). Filtration fraction was significantly decreased by CsA in group 4 (P less than 0.01 vs the control period). PAH renal extraction, urinary volume, and sodium and potassium excretion were similar in all groups before and after CsA. PRA and ADH were significantly increased only in group 4 (P less than 0.01) vs the baseline values. A high and significant relationship was detected between CsA dosage and the decrease of GFR (r = 0.81, P less than 0.001) and RPF (r = 0.612, P less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)
据我们所知,尚无研究评估低免疫抑制剂量的环孢素(CsA)对肾功能的急性影响。为确定CsA剂量与肾毒性发作之间是否存在关联,对28只大鼠在静脉注射不同剂量CsA之前(对照)和之后进行了肾脏清除率研究:3mg/kg体重(第1组);7mg/kg体重(第2组);11mg/kg体重(第3组);15mg/kg体重(第4组)。第1组和第2组在对照期和CsA给药后肾功能未观察到变化。第3组和第4组的肾小球滤过率(菊粉清除率)较对照期降低(分别为-22%和-37%,P<0.001);这两组之间的差异具有统计学意义(P<0.01)。第3组和第4组的有效肾血浆流量(对氨基马尿酸清除率)较其对照期同样降低(分别为-21%和-28%,P<0.001),原因是总肾血管阻力增加(分别为+41%和+42%,P<0.001)。第4组中CsA使滤过分数显著降低(与对照期相比P<0.01)。所有组在CsA给药前后对氨基马尿酸肾提取率、尿量以及钠和钾排泄均相似。仅第4组的肾素活性(PRA)和抗利尿激素(ADH)较基线值显著升高(P<0.01)。检测到CsA剂量与肾小球滤过率降低(r=0.81,P<0.001)和肾血浆流量降低(r=0.612,P<0.001)之间存在高度显著的相关性。(摘要截短于250字)