Tapp D C, Wortham W G, Addison J F, Hammonds D N, Barnes J L, Venkatachalam M A
Brooke Army Medical Center, Fort Sam Houston, Texas.
Lab Invest. 1989 Feb;60(2):184-95.
The objectives of this study were to evaluate the effects of food restriction (without protein or phosphorus restriction) and protein restriction (without the restriction of other nutrients or calories) on the outcome of the remnant kidney model of chronic renal failure in rats. After 5/6 nephrectomy, rats were assigned to one of the following dietary groups: group I (control-ad libitum) consumed a 21% casein diet ad libitum; group II (food restriction with protein restriction) consumed 36% less calories, protein and minerals than group I; group III (food restriction without protein restriction) consumed 36% less calories and minerals than group I, but equivalent amounts of protein; group IV (protein restriction) consumed 38% less protein than group I, but equivalent amounts of calories and minerals; group V (NaCl restriction) consumed 40% less sodium chloride than group I, but equivalent amounts of all other nutrients. All groups consumed equivalent amounts of calcium, phosphorus and vitamins. Groups II and III experienced retardation of growth in comparison to groups I, IV and V. The food-restricted groups II and III, but not groups IV and V, had less proteinuria than group I 20 weeks postablation. By 21 weeks postablation, the kidneys from group I showed severe parenchymal damage, characteristic of end-stage renal pathology. These changes were prevented in the food-restricted groups II and III, but not in groups IV and V. The percentage of glomeruli with severe structural damage was less in groups II (27.3 +/- 8.8) and III (26.9 +/- 7.5) compared with group I (72.4 +/- 7.8). In contrast, the corresponding values in groups IV and V were not significantly different from group I. Interstitial volume (the percentage of tubulointerstitium which is interstitium) which was proportional to the severity of tubular damage was significantly lower in groups II (25.1 +/- 4.5) and III (20.4 +/- 2.8) when compared with groups I (48.1 +/- 3.0), IV (44.4 +/- 6.6), or V (41.9 +/- 4.2). An interstitial volume less than 30 correlated with well preserved renal histology, whereas a value greater than 40 was indicative of end-stage renal pathology. These results indicate that the restriction of carbohydrate, fat, and minerals (except for calcium and phosphorus) retarded growth and prevented the development of end-stage renal pathology in the remnant kidney model of chronic renal failure in rats, regardless of whether protein was restricted or not.(ABSTRACT TRUNCATED AT 400 WORDS)
本研究的目的是评估食物限制(不限制蛋白质或磷)和蛋白质限制(不限制其他营养素或热量)对大鼠慢性肾衰竭残肾模型结果的影响。在进行5/6肾切除术后,将大鼠分为以下饮食组之一:第一组(自由摄食对照组)自由摄食21%酪蛋白饮食;第二组(食物限制伴蛋白质限制)摄入的热量、蛋白质和矿物质比第一组少36%;第三组(食物限制但无蛋白质限制)摄入的热量和矿物质比第一组少36%,但蛋白质含量相同;第四组(蛋白质限制)摄入的蛋白质比第一组少38%,但热量和矿物质含量相同;第五组(氯化钠限制)摄入的氯化钠比第一组少40%,但所有其他营养素含量相同。所有组摄入的钙、磷和维生素量相同。与第一、四和五组相比,第二和三组生长迟缓。在切除术后20周,食物限制组第二和三组的蛋白尿比第一组少,而第四和五组则不然。到切除术后21周,第一组的肾脏显示出严重的实质损伤,这是终末期肾脏病理的特征。这些变化在食物限制组第二和三组中得到预防,而在第四和五组中则没有。与第一组(72.4±7.8)相比,第二组(27.3±8.8)和第三组(26.9±7.5)中具有严重结构损伤的肾小球百分比更低。相比之下,第四和五组的相应值与第一组没有显著差异。与肾小管损伤严重程度成正比的间质体积(肾小管间质中为间质的百分比)在第二组(25.1±4.5)和第三组(20.4±2.8)中显著低于第一组(48.1±3.0)、第四组(44.4±6.6)或第五组(41.9±4.2)。间质体积小于30与肾脏组织学保存良好相关,而大于40的值则表明为终末期肾脏病理。这些结果表明,碳水化合物、脂肪和矿物质(除钙和磷外)的限制会延缓生长,并在大鼠慢性肾衰竭残肾模型中预防终末期肾脏病理的发展,无论蛋白质是否受到限制。(摘要截取自400字)