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放射性碘治疗后甲状腺功能亢进猫对称二甲基精氨酸和肾小球滤过率的变化。

Changes in symmetric dimethylarginine and glomerular filtration rates in hyperthyroid cats undergoing radioiodine therapy.

机构信息

Department of Veterinary Clinical Sciences, Iowa State University College of Veterinary Medicine, Ames, IA, USA.

出版信息

J Feline Med Surg. 2023 Mar;25(3):1098612X231160128. doi: 10.1177/1098612X231160128.

Abstract

OBJECTIVES

The aims of this study were to evaluate concentrations of symmetric dimethylarginine (SDMA) in hyperthyroid cats before and after radioiodine treatment, and to compare results with other variables used to assess kidney function in cats (creatinine, urine specific gravity [USG] and glomerular filtration rate [GFR] measured by renal scintigraphy).

METHODS

Thirteen cats diagnosed with hyperthyroidism based on clinical signs and increased serum total thyroxine (TT4) were included in this prospective study. Study design included physical examination, complete blood count, serum chemistry, TT4, urinalysis and SDMA before treatment (T0) and at 1 month (T1) and 3 months post-treatment (T3). GFR was quantified by renal scintigraphy at T0 and T3.

RESULTS

Median GFR decreased significantly from baseline (3.18 ml/kg/min; range 1.35-4.87) at T3 (2.22 ml/kg/min; range 1.81-3.42 [ = 0.005]). While median creatinine and serum urea nitrogen increased post-treatment (creatinine: T0 = 0.8 mg/dl [range 0.4-1.1], T1 = 1.3 mg/dl [range 0.9-2]; T3 = 1.65 mg/dl [range 0.8-2.8]; <0.001; serum urea nitrogen: T0 = 23 mg/dl [range 15-26]; T1 = 27 mg/dl [range 20-40]; T3 = 27.5 mg/dl [range 20-36]; <0.001), SDMA and USG did not change significantly (SDMA: T0 = 11 µg/dl [range 7-15]; T1 = 12 µg/dl [range 6-16]; T3 = 10.5 µg/dl [range 8-21];  = 0.789; USG: T0 = 1.030 [range 1.011-1.059]; T1 = 1.035 [range 1.012-1.044]; T3 = 1.030 [range 1.007-1.055];  = 0.792).

CONCLUSIONS AND RELEVANCE

Our data suggest that factors other than GFR may affect serum SDMA in hyperthyroid cats and that SDMA does not offer an advantage over other biomarkers traditionally used to predict changes in renal function following radioiodine therapy.

摘要

目的

本研究旨在评估放射性碘治疗前后甲状腺功能亢进猫的对称二甲基精氨酸(SDMA)浓度,并将结果与其他用于评估猫肾功能的变量(治疗前(T0)和治疗后 1 个月(T1)和 3 个月(T3)时的肌酐、尿比重[USG]和肾小球滤过率[GFR])进行比较。

方法

13 只基于临床症状和血清总甲状腺素(TT4)升高而诊断为甲状腺功能亢进的猫被纳入本前瞻性研究。研究设计包括体格检查、全血细胞计数、血清化学、TT4、尿液分析和治疗前(T0)和治疗后 1 个月(T1)和 3 个月(T3)的 SDMA。T0 和 T3 时通过肾闪烁照相术定量 GFR。

结果

T3 时 GFR 中位数从基线(3.18 ml/kg/min;范围 1.35-4.87)显著下降(2.22 ml/kg/min;范围 1.81-3.42[=0.005])。虽然治疗后肌酐和血清尿素氮升高(肌酐:T0=0.8 mg/dl[范围 0.4-1.1],T1=1.3 mg/dl[范围 0.9-2];T3=1.65 mg/dl[范围 0.8-2.8];<0.001;血清尿素氮:T0=23 mg/dl[范围 15-26];T1=27 mg/dl[范围 20-40];T3=27.5 mg/dl[范围 20-36];<0.001),SDMA 和 USG 无显著变化(SDMA:T0=11 μg/dl[范围 7-15];T1=12 μg/dl[范围 6-16];T3=10.5 μg/dl[范围 8-21];=0.789;USG:T0=1.030[范围 1.011-1.059];T1=1.035[范围 1.012-1.044];T3=1.030[范围 1.007-1.055];=0.792)。

结论和相关性

我们的数据表明,除 GFR 以外的因素可能会影响甲状腺功能亢进猫的血清 SDMA,并且 SDMA 在预测放射性碘治疗后肾功能变化方面并不优于传统上用于预测肾功能变化的其他生物标志物。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/beed/10812008/90df19384841/10.1177_1098612X231160128-fig1.jpg

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