Department of Internal Diseases, Nephrology and Dialysis, Military Institute of Health Services, Warsaw, Poland.
Arch Med Sci. 2012 Jul 4;8(3):555-62. doi: 10.5114/aoms.2012.29281.
Pathomechanism of HRS is still poorly understood. The aim of our study was: (1) to test whether different strains of rats could develop typical HRS, and (2) to estimate the influence of activation and inhibition of nitric oxide for development of renal failure in course of HRS.
First, we used 16 of Wistar and 16 of Sprague-Dawley rats in galactosamine model of HRS. Next, we used 48 of SDR rats, which received saline, N-nitro-L-arginine or L-arginine before and after liver damage. Twenty four hours urine and blood samples were collected 48 h after saline or Ga1N injection. Biochemical parameters were determined in serum or urine and then creatinine clearance and osmolality clearance were calculated. Liver and kidney tissues were collected for histopathological examination.
Liver failure developed in all tested groups with significant increase of bilirubin (p < 0.001), ALT (p < 0.001) and ammonia (p < 0.001). Nevertheless we did not achieve any evidence of renal failure in Wistar, but we found typical renal failure in Sprague-Dawley group with significant decrease in creatinine clearance (p < 0.0012) and increase in concentration of creatinine and urea (p < 0.001) and (p < 0.001) respectively. Inhibition of NOS prevented development of renal failure with significant improvement of GFR both before (p < 0.0017) and after (p < 0.003) Ga1N injection. Injection of L-arginine after Ga1N injection did not caused significant improvement of GFR.
Our study showed, that genetic factors might be responsible for development of renal failure in course of HRS and nitric oxide play important role in acute model of this syndrome.
肝肾综合征的发病机制仍不清楚。我们的研究目的是:(1)检测不同品系大鼠是否能发展为典型肝肾综合征;(2)评估一氧化氮的激活和抑制对肝肾综合征过程中肾功能衰竭的发展的影响。
首先,我们使用了 16 只 Wistar 大鼠和 16 只 Sprague-Dawley 大鼠的半乳糖胺肝肾综合征模型。接下来,我们使用了 48 只 SDR 大鼠,这些大鼠在肝损伤前后分别接受生理盐水、N-硝基-L-精氨酸或 L-精氨酸处理。在注射生理盐水或 Ga1N 后 48 小时收集 24 小时尿液和血液样本。在血清或尿液中测定生化参数,然后计算肌酐清除率和渗透清除率。收集肝和肾组织进行组织病理学检查。
所有测试组均发生肝衰竭,胆红素(p < 0.001)、丙氨酸转氨酶(p < 0.001)和氨(p < 0.001)显著升高。然而,我们在 Wistar 大鼠中没有发现任何肾功能衰竭的证据,但在 Sprague-Dawley 组中发现了典型的肾功能衰竭,肌酐清除率显著降低(p < 0.0012),肌酐和尿素浓度分别升高(p < 0.001)和(p < 0.001)。NOS 抑制可预防肾功能衰竭的发生,显著改善 Ga1N 注射前后的 GFR(分别为 p < 0.0017 和 p < 0.003)。Ga1N 注射后注射 L-精氨酸不能显著改善 GFR。
我们的研究表明,遗传因素可能是肝肾综合征过程中肾功能衰竭的原因,一氧化氮在该综合征的急性模型中发挥重要作用。