Kallerhoff M, Blech M, Kehrer G, Kleinert H, Langheinrich M, Siekmann W, Helmchen U, Bretschneider H J
Zentrum Physiologie und Pathophysiologie, Universität Göttingen, FRG.
Urol Res. 1987;15(4):215-22. doi: 10.1007/BF00262103.
Energy reserves (TAN) and anaerobic substrates (glucose, glycogen) are lower in renal than in myocardial tissue. Euro-Collins-solution contains nearly 200 mmol/l glucose, while the HTK-solution of Bretschneider contains none. Therefore the influence of glucose on kidney lactate production, on energy reserves (TAN), intrarenal pH and on morphology during the protection of ischemic kidneys was analysed using either Euro-Collins-solution, or modified "Euro-Collins-solution", containing mannitol instead of glucose, or HTK-solution with and without the addition of 5, 10 and 20 mmol/l glucose. Glucose content changed during kidney perfusion with Euro-Collins-solution from about 60 to 800 mumol/gdw. While intrarenal pH decreased from 7.1 to 5.1 in Euro-Collins-kidneys during 420 min of ischemia at 25 degrees C, pH decreased to 6.7 with the modified, mannitol containing "Euro-Collins-solution". In HTK-protected kidneys intrarenal pH decreased with increasing glucose addition to the solution. Although Total Adenine Nucleotides are highest at the end of ischemia with Euro-Collins-solution, structural protection after the same ischemic stress was best in HTK-protected kidneys without glucose addition. We conclude that glucose stimulated lactate production, reduced interstitial pH in the kidney even in combination with a highly buffered solution and that it might cause greater membrane permeability leading to a structural deterioration. Mannitol seemed more appropriate than glucose in this respect, although other substances, which provide energy substrate and prevent structural damage, may exist.
肾组织中的能量储备（三磷酸腺苷）和无氧底物（葡萄糖、糖原）比心肌组织中的要低。欧洲柯林斯液含有近200 mmol/L的葡萄糖，而布雷施奈德的HTK液则不含葡萄糖。因此，使用欧洲柯林斯液、不含葡萄糖而含甘露醇的改良“欧洲柯林斯液”或添加了5、10和20 mmol/L葡萄糖的HTK液，分析了葡萄糖对缺血性肾保护期间肾乳酸生成、能量储备（三磷酸腺苷）、肾内pH值及形态的影响。用欧洲柯林斯液灌注肾脏时，葡萄糖含量从约60 μmol/g干重变化到800 μmol/g干重。在25℃下缺血420分钟期间，欧洲柯林斯液处理的肾脏肾内pH值从7.1降至5.1，而含甘露醇的改良“欧洲柯林斯液”处理的肾脏pH值降至6.7。在HTK保护的肾脏中，随着溶液中葡萄糖添加量的增加，肾内pH值降低。尽管缺血结束时三磷酸腺苷总量在欧洲柯林斯液处理的肾脏中最高，但在相同缺血应激后，未添加葡萄糖的HTK保护的肾脏结构保护最佳。我们得出结论，葡萄糖刺激乳酸生成，即使与高缓冲溶液联合使用也会降低肾脏间质pH值，并且可能导致更大的膜通透性，从而导致结构恶化。在这方面，甘露醇似乎比葡萄糖更合适，尽管可能存在其他提供能量底物并防止结构损伤的物质。
