Robert D, Jeanmonod R, Favre H, Fruchart J C, Sturzenegger E, Riesen W
Dialysis Unit, Hôpital de la Providence, Neuchâtel, Switzerland.
Metabolism. 1989 Jun;38(6):514-21. doi: 10.1016/0026-0495(89)90210-2.
The role of the remmant kidney tissue in uremic patients undergoing hemodialysis treatment has rarely been considered to influence the changes in lipoprotein and lipid metabolism. Twenty hemodialyzed patients with remnant kidneys and 11 anephric patients were studied to examine whether the presence or the absence of remnant kidney leads to qualitative or quantitative changes of the lipids and lipoproteins. Anephric patients showed a significantly higher triglyceride level, 3.66 +/- 0.49 (SEM) mmol/L v 2.34 +/- 0.09 mmol/L in patients with remnant kidneys (P less than .01), higher very-low-density lipoprotein (VLDL) triglycerides, 1.24 +/- 0.30 mmol/L v 0.69 +/- 0.09 (P less than .04), and higher HDL-triglycerides, 1.22 +/- 0.29 mmol/L v 0.66 +/- 0.09 mmol/L (P less than .04). APO-AI was significantly decreased in anephric patients, 95.2 +/- 13.3 mg/dL v 129.7 +/- 6.02 mg/dL in patients with remnant kidneys (P less than .01). APO-B was similar in both groups. All APO-C and APO-E were significantly lower in anephric patients, APO-CI 6.13 +/- 0.87 mg/dL v 8.47 +/- 0.42 mg/dL in patients with remnant kidneys (P less than .01), APO CII 1.00 +/- 0.01 mg/dL v 10.0 +/- 0.01 mg/dL (P less than .0001), APO-CIII 10.12 +/- 1.43 mg/dL v 26.0 +/- 2.86 mg/dL (P less than .0005), and APO-E 8.0 +/- 0.02 mg/dL v 12.0 +/- 0.01 mg/dL (P less than .03). These results point out important differences between women and men. In women binephrectomy promotes a decreased concentration of all APO-C but has no influence on APO-AI concentration.(ABSTRACT TRUNCATED AT 250 WORDS)
残余肾组织在接受血液透析治疗的尿毒症患者中对脂蛋白和脂质代谢变化的影响很少被考虑。对20例有残余肾的血液透析患者和11例无肾患者进行研究,以检查有无残余肾是否会导致脂质和脂蛋白的质或量的变化。无肾患者的甘油三酯水平显著更高,分别为3.66±0.49(标准误)mmol/L和2.34±0.09 mmol/L(有残余肾的患者)(P<0.01),极低密度脂蛋白(VLDL)甘油三酯更高,分别为1.24±0.30 mmol/L和0.69±0.09(P<0.04),高密度脂蛋白甘油三酯也更高,分别为1.22±0.29 mmol/L和0.66±0.09 mmol/L(P<0.04)。无肾患者的载脂蛋白A-I显著降低,分别为95.2±13.3 mg/dL和129.7±6.02 mg/dL(有残余肾的患者)(P<0.01)。两组的载脂蛋白B相似。所有载脂蛋白C和载脂蛋白E在无肾患者中均显著更低,载脂蛋白CI分别为6.13±0.87 mg/dL和8.47±0.42 mg/dL(有残余肾的患者)(P<0.01),载脂蛋白CII分别为1.00±0.01 mg/dL和10.0±0.01 mg/dL(P<0.0001),载脂蛋白CIII分别为10.12±1.43 mg/dL和26.0±2.86 mg/dL(P<0.0005),载脂蛋白E分别为8.0±0.02 mg/dL和12.0±0.01 mg/dL(P<0.03)。这些结果指出了男性和女性之间的重要差异。在女性中,双侧肾切除术会导致所有载脂蛋白C浓度降低,但对载脂蛋白A-I浓度没有影响。(摘要截选至250词)