Kraus E, Teller D, Cheng L, Briefel G, Sacktor B, Spector D
Francis Scott Key Medical Center, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Md.
Miner Electrolyte Metab. 1990;16(4):202-9.
Urinary calcium excretion (UCa) is normal several weeks following subtotal nephrectomy (Nx) in the rat, despite factors such as magnified solute load per nephron which should promote hypercalciuria. To define the levels of UCa during the first few weeks after Nx and to determine if the development of compensatory mechanisms governing renal conservation of calcium are detectable, we measured UCa in Nx and sham Nx rats with matched food intake (10 g/day) from 10 days before through 20 days following Nx. In the sham Nx animals, UCa rose during the first 5 days following surgery from 27 +/- 8 to 66 +/- 5 microM/day and then plateaued for the remaining time. In Nx rats, UCa also rose during the first 5 postoperative days from 23 +/- 5 to 110 +/- 10 microM/day (Nx vs. sham Nx, p less than 0.05), but then fell over the next 3 days to levels observed simultaneously in sham Nx animals. The rise in UCa after Nx, but not after sham Nx, was associated with a doubling of urine flow rate and increased urinary titratable acid excretion. In parathyroidectomized rats, UCa also rose following Nx; however, maximum UCa was then sustained for at least 4 days. In an additional sham Nx group fed 20 g/day, no increase in UCa occurred following surgery. Thus, hypercalciuria is present following Nx in the rat, in part possibly attributable to increased acid excretion. The transient nature of calciuria reflects an adaptive phenomenon, most likely hyperparathyroidism. Diminished food intake following surgery independently contributes to hypercalciuria, regardless of the status of renal mass.
大鼠肾次全切除术后几周内尿钙排泄(UCa)正常,尽管存在如每个肾单位溶质负荷增加等应会促进高钙尿症的因素。为了确定肾次全切除术后最初几周内的尿钙水平,并确定是否能检测到控制肾脏钙保留的代偿机制的发展,我们测量了肾次全切除和假手术的大鼠从肾次全切除术前10天到术后20天的尿钙水平,这些大鼠的食物摄入量匹配(10克/天)。在假手术动物中,术后前5天尿钙从27±8微摩尔/天升至66±5微摩尔/天,然后在剩余时间保持稳定。在肾次全切除的大鼠中,术后前5天尿钙也从23±5微摩尔/天升至110±10微摩尔/天(肾次全切除组与假手术组相比,p<0.05),但在接下来的3天内降至假手术动物同时观察到的水平。肾次全切除术后尿钙升高,但假手术术后未出现,这与尿流率加倍和尿中可滴定酸排泄增加有关。在甲状旁腺切除的大鼠中,肾次全切除术后尿钙也升高;然而,尿钙最高值随后至少维持4天。在另一个每天喂食20克的假手术组中,术后尿钙没有增加。因此,大鼠肾次全切除术后存在高钙尿症,部分原因可能是酸排泄增加。尿钙的短暂性质反映了一种适应性现象,很可能是甲状旁腺功能亢进。手术后继发的食物摄入量减少独立地导致高钙尿症,而与肾质量状况无关。