Buck A C, Lote C J, Sampson W F
J Urol. 1983 Feb;129(2):421-6. doi: 10.1016/s0022-5347(17)52130-8.
Hypercalciuria is well recognized as an important factor in the cause of idiopathic calcium stone disease. Identification of the exact mechanism for the renal tubular handling of calcium has proved elusive, hence, treatment methods to alter the concentration of urine calcium in hypercalciuric stone formers have hitherto been non-specific. It is now well established that renal prostaglandins influence intrarenal hemodynamics and tubular electrolyte excretion. As the renal handling of sodium and calcium is intimately related, the possibility that the mechanism underlying hypercalciuria may be prostaglandin mediated was considered. Experiments were performed in conscious Sprague-Dawley rats (n = 10) to determine the changes in calcium excretion following prostaglandin synthetase inhibition with indomethacin. Calcium excretion was significantly reduced (p less than 0.01), compared with control animals (n = 10). Further experiments were performed in anesthetized monkeys (Macaca fascicularis) to see if the inhibitory effect of indomethacin was reversible. Exogenous prostaglandin (PGE2) infusion resulted in a marked calciuretic response without producing changes in glomerular filtration rate or blood pressure. Forty-three hypercalciuric patients were treated with a prostaglandin inhibitor for periods ranging from 2 to 4 weeks, and all showed a significant fall in urinary calcium excretion to within the normal range. This clinical and experimental study suggests that prostaglandin (PGE2) is a hormone which determines the renal handling of calcium by influencing renal tubular function.
高钙尿症被公认为特发性钙结石病病因中的一个重要因素。事实证明，确定肾小管处理钙的确切机制很困难，因此，迄今为止，改变高钙尿结石形成者尿钙浓度的治疗方法一直缺乏特异性。现已明确，肾前列腺素会影响肾内血流动力学和肾小管电解质排泄。由于肾脏对钠和钙的处理密切相关，因此人们考虑高钙尿症潜在机制可能由前列腺素介导的可能性。对清醒的斯普拉格-道利大鼠（n = 10）进行实验，以确定用吲哚美辛抑制前列腺素合成酶后钙排泄的变化。与对照动物（n = 10）相比，钙排泄显著减少（p < 0.01）。在麻醉的猕猴（食蟹猴）身上进行了进一步实验，以观察吲哚美辛的抑制作用是否可逆。外源性前列腺素（PGE2）输注导致明显的利钙反应，而肾小球滤过率或血压没有变化。43例高钙尿症患者接受前列腺素抑制剂治疗2至4周，所有患者尿钙排泄均显著下降至正常范围内。这项临床和实验研究表明，前列腺素（PGE2）是一种通过影响肾小管功能来决定肾脏对钙处理的激素。
