Schaefer R M, Teschner M, Weissinger F, Duelk M J, Peter G, Heidland A
Department of Internal Medicine, University of Würzburg, FRG.
Nephron. 1989;51(1):67-72. doi: 10.1159/000185245.
Both ethanol consumption and uremia are considered to be associated with wasting, malnutrition and debilitation. The present study was designed to investigate as to whether ethanol exerts a stimulatory effect on the catabolic state of renal failure. Rats underwent 5/6-nephrectomy and were fed either with or without ethanol. The degree of uremia was comparable in both groups. Ethanol-fed uremic rats, however, displayed higher serum levels of urea (+ 103%) and glucose (+29%), as compared to uremic animals without alcohol. Subsequently, the urea N appearance was enhanced (+60%) in uremic rats with alcohol as compared to uremic animals without alcohol. In sham rats urea N appearance was also increased (+39%) following ethanol administration in comparison to sham-operated rats without alcohol, albeit to a lesser degree. Urinary Nt-methylhistidine excretion, an indicator of myofibrillar protein breakdown, was enhanced throughout the experiment in uremic rats receiving ethanol. Finally, ethanol caused higher urinary excretion rates of corticosterone in uremic animals as compared to uremic rats without ethanol. There was a significant correlation between urinary corticosterone excretion and both urea N appearance and urinary Nt-methylhistidine excretion. We conclude that ethanol consumption further aggravates the catabolic state of uremia and that this is mediated by an increment in glucocorticoid production.
乙醇摄入和尿毒症都被认为与消瘦、营养不良和身体虚弱有关。本研究旨在调查乙醇是否对肾衰竭的分解代谢状态产生刺激作用。对大鼠进行5/6肾切除术,并分别给予含乙醇或不含乙醇的饲料。两组的尿毒症程度相当。然而,与未饮酒的尿毒症动物相比,饮用乙醇的尿毒症大鼠血清尿素水平升高(+103%),血糖水平升高(+29%)。随后,与未饮酒的尿毒症动物相比,饮酒的尿毒症大鼠尿素氮生成增加(+60%)。与未饮酒的假手术大鼠相比,假手术大鼠在给予乙醇后尿素氮生成也增加(+39%),尽管增加程度较小。在整个实验过程中,接受乙醇的尿毒症大鼠尿N-甲基组氨酸排泄增加,这是肌原纤维蛋白分解的一个指标。最后,与未饮用乙醇的尿毒症大鼠相比,乙醇使尿毒症动物尿皮质酮排泄率更高。尿皮质酮排泄与尿素氮生成及尿N-甲基组氨酸排泄之间存在显著相关性。我们得出结论,乙醇摄入会进一步加重尿毒症的分解代谢状态,这是由糖皮质激素生成增加介导的。