Schramm L, Heidbreder E, Kartenbender K, Schmitt A, Zimmermann J, Lopau K, Ling H, Heidland A
Department of Medicine, University of Würzburg, Germany.
Am J Nephrol. 1995;15(5):418-26. doi: 10.1159/000168876.
In humans as well as in experimental models the hallmark of ischemic acute renal failure (ARF) is a profound diminution in glomerular filtration rate (GFR) and renal blood flow. Both calcium antagonists and a-ANP have been reported to exert beneficial effects in ischemic ARF. No data, however, exist about combined administration of the natriuretic peptide urodilatin and calcium channel blockers. We therefore investigated the effects of urodilatin (URO, 40 micrograms/kg/h, i.v.) and diltiazem (DIL, 300 micrograms/kg/h, i.v.) in the rat given immediately after clamping of both renal arteries for 40 min. Compared to controls (0.07 +/- 0.01) depressed GFR (ml/min/100 g) was clearly elevated with URO (0.16 +/- 0.03), DIL (0.13 +/- 0.03) and URO + DIL (0.14 +/- 0.02) after the ischemic lesion. After cessation of drug delivery the beneficial effects were blunted in the URO group, in contrast to the DIL and URO + DIL group, where GFR was significantly elevated compared to controls even 3 h after starting reperfusion. Besides that also urine flow, sodium excretion and blood pressure were examined. In conclusion both URO and DIL exert beneficial effects in ischemic ARF in the rat while infused. In contrast to URO DIL showed prolonged beneficial effects even after cessation of drug delivery. An additional effect of both drugs could not be observed.
在人类以及实验模型中,缺血性急性肾衰竭(ARF)的标志是肾小球滤过率(GFR)和肾血流量显著降低。据报道,钙拮抗剂和α-心钠素(a-ANP)在缺血性ARF中均发挥有益作用。然而,关于利钠肽尿舒张素和钙通道阻滞剂联合给药的数据尚不存在。因此,我们研究了在双侧肾动脉夹闭40分钟后立即给予大鼠尿舒张素(URO,40微克/千克/小时,静脉注射)和地尔硫䓬(DIL,300微克/千克/小时,静脉注射)的效果。与对照组(0.07±0.01)相比,缺血损伤后,URO组(0.16±0.03)、DIL组(0.13±0.03)和URO + DIL组(0.14±0.02)的GFR(毫升/分钟/100克)明显升高。停止给药后,URO组的有益效果减弱,而DIL组和URO + DIL组则相反,即使在再灌注开始3小时后,其GFR仍显著高于对照组。此外,还检测了尿流量、钠排泄和血压。总之,URO和DIL在输注时对大鼠缺血性ARF均发挥有益作用。与URO不同,DIL即使在停止给药后仍显示出延长的有益效果。未观察到两种药物的额外作用。