Hsu C H, Patel S, Young E W, Simpson R U
Department of Internal Medicine and Pharmacology, University of Michigan, Ann Arbor 48109.
Am J Physiol. 1987 Nov;253(5 Pt 2):F1015-9. doi: 10.1152/ajprenal.1987.253.5.F1015.
We studied the metabolism of calcitriol in renal failure achieved by nephrectomy in three groups of rats. Group 1 (n = 7) had sham operation of nephrectomy. Group 2 (n = 8) had unilateral nephrectomy. Group 3 (n = 7) had 5/6 nephrectomy. Metabolic clearance rate (MCR) and production rate (PR) of calcitriol were studied 3 wk after the surgery. Serum creatinine concentrations were increased after nephrectomy for groups 2 and 3. Endogenous plasma levels of calcitriol were not different between the rats with renal failure and the controls. MCR of calcitriol were decreased in renal failure rats compared with controls (group 1, 0.24 +/- 0.01; group 2, 0.20 +/- 0.01, P less than 0.01; group 3, 0.16 +/- 0.01 ml.min-1.kg-1, P less than 0.001). The MCR of calcitriol was correlated with the endogenous creatinine clearance by linear regression analysis (r = 0.72, P less than 0.001). The PR of calcitriol were also decreased in renal failure; however, the decreases were much less than the amount of renal tissue removed. We concluded that production of calcitriol is decreased in the remnant kidney. The decreased synthesis is associated with decreased degradation of calcitriol resulting in normal concentrations of calcitriol in mild to moderately severe renal failure.
我们研究了三组大鼠肾切除所致肾衰竭时骨化三醇的代谢情况。第1组(n = 7)行假肾切除手术。第2组(n = 8)行单侧肾切除。第3组(n = 7)行5/6肾切除。术后3周研究骨化三醇的代谢清除率(MCR)和生成率(PR)。第2组和第3组肾切除术后血清肌酐浓度升高。肾衰竭大鼠与对照组的内源性骨化三醇血浆水平无差异。与对照组相比,肾衰竭大鼠的骨化三醇MCR降低(第1组,0.24±0.01;第2组,0.20±0.01,P<0.01;第3组,0.16±0.01 ml·min⁻¹·kg⁻¹,P<0.001)。通过线性回归分析,骨化三醇的MCR与内源性肌酐清除率相关(r = 0.72,P<0.001)。肾衰竭时骨化三醇的PR也降低;然而,降低幅度远小于切除的肾组织量。我们得出结论,残余肾中骨化三醇的生成减少。合成减少与骨化三醇降解减少有关,导致轻度至中度严重肾衰竭时骨化三醇浓度正常。