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单侧肾切除术后六个月大鼠的肾功能受损——一个老话题,一个新视角。

Impaired kidney function in rats six months after unilateral nephrectomy - an old story, a new perspective.

作者信息

Orsić Vlasta, Mihalj Martina, Mogus Mate, Mihalj Hrvoje, Jakić Marko, Heffer-Lauc Marija, Marjanović Ksenija, Zibar Lada

机构信息

Department of Pathophysiology, Faculty of Medicine Josip Juraj Strossmayer, University of Osijek, Croatia.

出版信息

Med Glas (Zenica). 2011 Aug;8(2):185-91.

Abstract

AIM

Despite of routinely practised living kidney transplantation, data on consequences and impact of unilateral nephrectomy on the quality of life and health of donors are scarce. The aim of the present study was to examine long-term changes and function of the remnant kidney after unilateral nephrectomy in an animal model.

METHODS

Thirty six female Sprague - Dawley rats at 4 months of age were randomized into the three groups: unilaterally nephrectomized, sham operated and naïve rats. The nephrectomy was done at inclusion in the experiment and their blood was taken at inclusion and six months thereafter.

RESULTS

There was a significant increase in serum creatinine concentrations six months after unilateral nephrectomy (39.7 ± 0.8 μmol/l) in comparison with the sham operated (30.1 ± 1.1 μmol/l) and the naïve rats (26.3 ± 3 μmol/l) (p ≤ 0.001). Serum sodium levels remained unchanged (p=0.116). Blood haemoglobin concentration did not differ between the three groups (p=0.115).

CONCLUSIONS

Although it has been very well established that kidney possesses huge capacity to compensate severe loss of renal mass, our results implicate that renal function undergoes significant deterioration with time after unilateral nephrectomy. Fortunately, in everyday clinical practice we do not see severe renal dysfunction in patients with a single kidney. However, prolongation of the human life span in the future could face us with renal impairment in living kidney donors. Future examination of specific biomarkers in our rat model (e.g. growth factors) could support our findings.

摘要

目的

尽管活体肾移植已常规开展,但关于单侧肾切除对供体生活质量和健康的影响及后果的数据却很匮乏。本研究的目的是在动物模型中研究单侧肾切除术后残余肾脏的长期变化及功能。

方法

将36只4月龄雌性斯普拉格-道利大鼠随机分为三组:单侧肾切除组、假手术组和未处理组。在实验开始时进行肾切除术,并在纳入实验时及此后6个月采集它们的血液。

结果

与假手术组(30.1±1.1μmol/l)和未处理组(26.3±3μmol/l)相比,单侧肾切除术后6个月血清肌酐浓度显著升高(39.7±0.8μmol/l)(p≤0.001)。血清钠水平保持不变(p=0.116)。三组之间血红蛋白浓度无差异(p=0.115)。

结论

尽管已经充分证实肾脏具有巨大的能力来代偿严重的肾实质损失,但我们的结果表明,单侧肾切除术后肾功能会随着时间的推移而显著恶化。幸运的是,在日常临床实践中,我们并未在单肾患者中看到严重的肾功能障碍。然而,未来人类寿命的延长可能会使活体肾供体面临肾功能损害。在我们的大鼠模型中对特定生物标志物(如生长因子)进行进一步研究可能会支持我们的发现。

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