Bagnis C, Deray G, Dubois M, Jacquiaud C, Bitker M O, Jacobs C
Department of Nephrology, Hôpital Pitie-Salpetriere, Paris, France.
Nephrol Dial Transplant. 1994;9(8):1143-8. doi: 10.1093/ndt/9.8.1143.
Nephrotoxicity is the most common and important side-effect of cyclosporin (CsA) therapy. CsA alters renal haemodynamics with a reduction in renal blood flow (RBF) and glomerular filtration rate (GFR) and a significant increase in renal vascular resistances (RVR). The present experimental study investigates whether verapamil or atrial natriuretic factor (ANF) are able to prevent the nephrotoxicity of CsA. All studies were conducted in an in-situ autoperfused rat kidney model which allows continuous measurement of renal blood flow without dissection of the renal artery. CsA as a 40 mg/kg bolus dose significantly decreased RBF (from 2.15 +/- 0.1 and 2.19 +/- 0.1 before CsA, to 1.29 +/- 0.16 ml/min/100 g BW, 60 min after CsA administration) (P < 0.05), and GFR (from 0.14 +/- 0.1 and 0.13 +/- 0.01 before CsA, to 0.08 +/- 0.01 ml/min/100 g BW, 60 min after CsA administration) (P < 0.05). CsA significantly increased RVR (from 9.5 +/- 0.73 and 9.8 +/- 0.78 before CsA, to 16.7 +/- 2.9 mmHg x min/ml 60 min after CsA administration) (P < 0.05). Verapamil pretreatment (as continuous intrarenal infusion at the rate of 1.25 micrograms/kg/min) attenuated the fall in GFR (from 0.16 +/- 0.01 and 0.19 +/- 0.03 ml/min/100 g before CsA to 0.20 +/- 0.05 ml/min/100 g BW, 60 min after CsA administration) (NS) and in RBF (from 2.42 +/- 0.2 and 2.6 +/- 0.22 ml/min/100 g before CsA to 1.79 +/- 0.17 ml/min/100 g BW, 60 min after CsA administration (P < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)
肾毒性是环孢素(CsA)治疗最常见且最重要的副作用。CsA会改变肾脏血流动力学,导致肾血流量(RBF)和肾小球滤过率(GFR)降低,肾血管阻力(RVR)显著增加。本实验研究旨在探讨维拉帕米或心房利钠因子(ANF)是否能够预防CsA的肾毒性。所有研究均在原位自体灌注大鼠肾脏模型中进行,该模型可在不解剖肾动脉的情况下连续测量肾血流量。CsA以40mg/kg的大剂量推注显著降低了RBF(CsA给药前为2.15±0.1和2.19±0.1,给药60分钟后降至1.29±0.16ml/min/100g体重)(P<0.05),以及GFR(CsA给药前为0.14±0.1和0.13±0.01,给药60分钟后降至0.08±0.01ml/min/100g体重)(P<0.05)。CsA显著增加了RVR(CsA给药前为9.5±0.73和9.8±0.78,给药60分钟后升至16.7±2.9mmHg·min/ml)(P<0.05)。维拉帕米预处理(以1.25μg/kg/min的速率持续肾内输注)减轻了GFR的下降(CsA给药前为0.16±0.01和0.19±0.03ml/min/100g,给药60分钟后为0.20±0.05ml/min/100g体重)(无显著性差异)以及RBF的下降(CsA给药前为2.42±0.2和2.6±0.22ml/min/100g,给药60分钟后为1.79±0.17ml/min/100g体重)(P<0.05)。(摘要截断于250字)