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单侧肾切除术后环孢素肾毒性中的肾小球血流动力学

Glomerular hemodynamics in cyclosporine nephrotoxicity following uninephrectomy.

作者信息

Winston J A, Feingold R, Safirstein R

机构信息

Department of Medicine, Mount Sinai School of Medicine, New York, New York.

出版信息

Kidney Int. 1989 May;35(5):1175-82. doi: 10.1038/ki.1989.107.

Abstract

Experiments were performed to determine the cause of the reduced glomerular filtration rate (GFR) in cyclosporine nephrotoxicity during compensatory renal growth. Sprague-Dawley rats were uninephrectomized and given daily injections of cyclosporine (30 mg/kg, i.m.) or vehicle (olive oil), and studied 7 or 14 days later. In cyclosporine treated rats GFR was lower seven days (1.34 +/- 0.10 vs. 1.68 +/- 0.07 ml/min) and 14 days (1.19 +/- 0.08 vs. 1.58 +/- 0.04, P less than 0.025) following uninephrectomy. Arterial blood pressure, cardiac output and renal blood flow (RBF) were not different in cyclosporine and control rats. Kidney mass increased to the same extent in cyclosporine and control rats. Micropuncture of the glomerular microcirculation in similarly prepared Munich-Wistar rats demonstrated low whole kidney GFR (1.10 +/- 0.07 vs. 1.55 +/- 0.13 ml/min, P less than 0.01), and single nephron GFR (31.07 +/- 2.27 vs. 42.36 +/- 2.47 nl/min, P less than 0.005) in cyclosporine treated rats as compared to controls. Single nephron plasma flow, afferent and efferent arteriolar resistance, the transglomerular hydrostatic pressure gradient, and arterial blood pressure were the same in both groups. The glomerular capillary ultrafiltration coefficient (Kf) was lower in cyclosporine treated rats compared to controls [0.039 +/- 0.002 vs. 0.075 +/- 0.013 nl/(sec.mm Hg), P less than 0.025]. We conclude that in this model of cyclosporine nephrotoxicity the low GFR is caused solely by a reduction in Kf, and that cyclosporine can reduce GFR without causing renal vasoconstriction.

摘要

进行实验以确定在代偿性肾生长期间环孢素肾毒性导致肾小球滤过率(GFR)降低的原因。将Sprague-Dawley大鼠进行单侧肾切除,并每天注射环孢素(30mg/kg,肌肉注射)或溶剂(橄榄油),并在7天或14天后进行研究。在环孢素处理的大鼠中,单侧肾切除后7天(1.34±0.10对1.68±0.07ml/min)和14天(1.19±0.08对1.58±0.04,P<0.025)GFR较低。环孢素处理的大鼠和对照大鼠的动脉血压、心输出量和肾血流量(RBF)没有差异。环孢素处理的大鼠和对照大鼠的肾脏重量增加程度相同。在同样制备的慕尼黑-威斯塔大鼠中,对肾小球微循环进行微穿刺显示,与对照相比,环孢素处理的大鼠全肾GFR较低(1.10±0.07对1.55±0.13ml/min,P<0.01),单个肾单位GFR较低(31.07±2.27对42.36±2.47nl/min,P<0.005)。两组的单个肾单位血浆流量、入球和出球小动脉阻力、跨肾小球静水压力梯度和动脉血压相同。与对照相比,环孢素处理的大鼠肾小球毛细血管超滤系数(Kf)较低[0.039±0.002对0.075±0.013nl/(秒·毫米汞柱),P<0.025]。我们得出结论,在这种环孢素肾毒性模型中,低GFR仅由Kf降低引起,并且环孢素可降低GFR而不引起肾血管收缩。

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