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尿毒症性肾钙质沉着症中的钙代谢:维拉帕米的预防作用

Calcium metabolism in uremic nephrocalcinosis: preventive effect of verapamil.

作者信息

Goligorsky M S, Chaimovitz C, Rapoport J, Goldstein J, Kol R

出版信息

Kidney Int. 1985 May;27(5):774-9. doi: 10.1038/ki.1985.79.

Abstract

The aim of the present study was to examine calcium metabolism of the renal cortex in experimental chronic renal failure, together with morphologic criteria of nephrocalcinosis and to determine the effect of chronic verapamil administration on these parameters. In subtotally nephrectomized (SNX) rats 3 weeks after surgery, renal cortical calcium content increased more than two-fold. 45Ca incorporation into renal cortical slices in SNX revealed a 35% increase, associated with a 50% increase in a lanthanum-resistant fraction of 45Ca uptake. Radiocalcium wash-out curves in this group demonstrated abnormal retention of the isotope for up to 30 min of incubation. In contrast, radiocalcium incorporation and wash-out in SNX rats chronically treated with verapamil were similar to that obtained in the sham group. Verapamil administration significantly reduced, but did not normalize, renal cortical calcium content. Von Kossa staining demonstrated the deposition of calcium in the renal parenchyma of SNX rats. Ultrastructurally, it was accompanied by mitochondrial disorganization and calcification, as well as by the tubular basement membrane destruction and mineralization. These morphologic patterns of nephrocalcinosis were significantly ameliorated in SNX rats treated with verapamil. We conclude that chronic verapamil administration results in amelioration of uremic nephrocalcinosis.

摘要

本研究的目的是检测实验性慢性肾衰竭时肾皮质的钙代谢情况,以及肾钙质沉着症的形态学标准,并确定长期给予维拉帕米对这些参数的影响。在接受次全肾切除术(SNX)的大鼠术后3周,肾皮质钙含量增加了两倍多。SNX大鼠肾皮质切片对45Ca的摄取显示增加了35%,同时对45Ca摄取的镧抗性部分增加了50%。该组的放射性钙洗脱曲线显示,在长达30分钟的孵育过程中,同位素存在异常潴留。相比之下,长期接受维拉帕米治疗的SNX大鼠的放射性钙摄取和洗脱与假手术组相似。给予维拉帕米可显著降低肾皮质钙含量,但未能使其恢复正常。冯·科萨染色显示SNX大鼠肾实质中有钙沉积。超微结构上,伴有线粒体紊乱和钙化,以及肾小管基底膜破坏和矿化。在用维拉帕米治疗的SNX大鼠中,这些肾钙质沉着症的形态学模式得到了显著改善。我们得出结论,长期给予维拉帕米可改善尿毒症性肾钙质沉着症。

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