Division of Pediatric Nephrology, Children's Research Institute, Children's National Medical Center, Washington, DC, USA.
Pediatr Res. 2013 Feb;73(2):194-200. doi: 10.1038/pr.2012.172. Epub 2012 Nov 22.
Nephrocalcinosis (NC) is an important clinical problem seen in critically ill preterm neonates treated with loop diuretics. No reliable animal models are available to study the pathogenesis of NC in preterm infants. The purpose of this study was to develop a reproducible and clinically relevant animal model of NC for these patients and to explore the impact of extracellular fluid (ECF) volume contraction induced by sodium and chloride depletion in this process.
Three-week-old weanling Sprague-Dawley rats were fed diets deficient in either chloride or sodium or both. A subgroup of rats from each dietary group was injected daily with furosemide (40 mg/kg i.p.).
Rats fed a control diet, with or without furosemide, or a chloride-depleted diet alone, did not develop NC. By contrast, 50% of the rats injected with furosemide and fed the chloride-depleted diet developed NC. Moreover, 94% of the rats fed the combined sodium- and chloride-depleted diet developed NC, independently of furosemide use. NC was associated with the development of severe ECF volume contraction; hypochloremic, hypokalemic, metabolic alkalosis; increased phosphaturia; and growth retardation.
Severe ECF volume contraction induced by chronic sodium and chloride depletion appears to play an important role in the pathogenesis of NC.
肾钙质沉着症(NC)是接受袢利尿剂治疗的危重新生早产儿中常见的重要临床问题。目前尚无可靠的动物模型可用于研究早产儿 NC 的发病机制。本研究旨在为这些患者开发一种可重现且与临床相关的 NC 动物模型,并探讨在该过程中由钠和氯耗竭引起的细胞外液(ECF)体积收缩的影响。
3 周龄断奶的 Sprague-Dawley 大鼠喂食缺乏氯或钠或两者的饮食。每组饮食的一部分大鼠每天接受呋塞米(40mg/kg 腹腔注射)注射。
接受呋塞米或不接受呋塞米的对照饮食或单独缺乏氯饮食的大鼠均未发生 NC。相比之下,50%接受呋塞米和缺乏氯饮食的大鼠发生了 NC。此外,94%同时缺乏钠和氯的饮食的大鼠发生了 NC,而与使用呋塞米无关。NC 与严重的 ECF 体积收缩、低氯血症、低钾血症、代谢性碱中毒、尿磷排泄增加和生长迟缓有关。
慢性钠和氯耗竭引起的严重 ECF 体积收缩似乎在 NC 的发病机制中起重要作用。