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中枢性尿崩症患者经血管加压素治疗前后口服蛋白负荷后的肾脏反应。

Renal response to an oral protein load in patients with central diabetes insipidus before and after treatment with vasopressin.

机构信息

Division of Nephrology, Department of Scienze mediche traslazionali, Università della Campania "L. Vanvitelli", Padiglione 17, via Pansini 5, 80131, Naples, Italy.

Università della Campania "L. Vanvitelli", Naples, Italy.

出版信息

J Nephrol. 2019 Jun;32(3):411-415. doi: 10.1007/s40620-018-00575-x. Epub 2019 Feb 19.

DOI:10.1007/s40620-018-00575-x
PMID:30778919
Abstract

AIM

Different factors have been hypothesized to play a role in the cascade of events associated with the protein-induced glomerular response. However, scant data are available on the possible functional effect of vasopressin (VP) on the glomerular filtration rate (GFR) in humans with central diabetes insipidus (CDI), which was the aim of the present study.

METHOD

Renal function was studied under fasting conditions (baseline) and after a meat meal in 16 patients with CDI before and after treatment with desmopressin (DDAVP) and in 16 control subjects. GFR was measured by the inulin method.

RESULTS

At baseline, the GFR was lower in patients with CDI. Treatment with DDAVP resulted in an insignificant increase in GFR, which was not statistically different from untreated patients. After an acute oral protein load, the GFR increased, peaking at 45 min post meal in controls, and at 135 min post meal in treated and untreated CDI patients.

CONCLUSION

After a meat meal, the peak GFR response is delayed in CDI patients suggesting that VP might indirectly affect tubule-glomerular feedback.

摘要

目的

不同的因素被假设在与蛋白诱导的肾小球反应相关的级联事件中发挥作用。然而,关于抗利尿激素(VP)对中枢性尿崩症(CDI)患者肾小球滤过率(GFR)的可能功能影响的数据很少,这是本研究的目的。

方法

在禁食条件下(基线)和在使用去氨加压素(DDAVP)治疗前后,对 16 例 CDI 患者进行了肾功能研究,并在 16 例对照者中进行了研究。GFR 通过菊粉法测量。

结果

在基线时,CDI 患者的 GFR 较低。DDAVP 治疗后,GFR 出现无显著性增加,与未治疗患者无统计学差异。在急性口服蛋白质负荷后,GFR 增加,在对照组中于餐后 45 分钟达到峰值,在治疗和未治疗的 CDI 患者中于餐后 135 分钟达到峰值。

结论

在吃肉餐后,CDI 患者的 GFR 峰值反应延迟,表明 VP 可能间接影响管球反馈。

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