Niwa T, Ise M
Department of Clinical Laboratory, Nagoya University Branch Hospital, Japan.
J Lab Clin Med. 1994 Jul;124(1):96-104.
To determine the role of indoxyl sulfate in the progression of glomerular sclerosis, the serum level of indoxyl sulfate was measured in patients with uremia, and the effect of oral administration of indoxyl sulfate on renal function and renal histology was studied in subtotally nephrectomized uremic rats. Further, the effects of a low-protein diet and oral sorbent (AST-120) administration on the serum and urine levels of indoxyl sulfate were studied in different groups of subtotally nephrectomized uremic rats. We noted a marked elevation of serum level of indoxyl sulfate in the patients with uremia. The oral administration of indoxyl sulfate to the uremic rats increased the serum creatinine and blood urea nitrogen levels and decreased creatinine clearance, inulin clearance, and p-aminohippuric acid clearance. The glomerular sclerosis index in the indoxyl sulfate-administered uremic rats was higher than in the control uremic rats. A low-protein diet and AST-120 administration decreased the serum and urine levels of indoxyl sulfate, the blood urea nitrogen level, the urinary protein level, and the glomerular sclerosis index in the uremic rats as compared with those on a high-protein diet. Thus, indoxyl sulfate, a circulating uremic toxin, stimulated the progression of glomerular sclerosis in the uremic model. A low-protein diet and AST-120 reduced the serum and urine levels of indoxyl sulfate and suppressed the progression of glomerular sclerosis.
为了确定硫酸吲哚酚在肾小球硬化进展中的作用，我们检测了尿毒症患者血清中硫酸吲哚酚的水平，并在次全肾切除的尿毒症大鼠中研究了口服硫酸吲哚酚对肾功能和肾脏组织学的影响。此外，我们还在不同组的次全肾切除尿毒症大鼠中研究了低蛋白饮食和口服吸附剂（AST-120）对血清和尿液中硫酸吲哚酚水平的影响。我们注意到尿毒症患者血清中硫酸吲哚酚水平显著升高。给尿毒症大鼠口服硫酸吲哚酚会增加血清肌酐和血尿素氮水平，并降低肌酐清除率、菊粉清除率和对氨基马尿酸清除率。给予硫酸吲哚酚的尿毒症大鼠的肾小球硬化指数高于对照尿毒症大鼠。与高蛋白饮食的大鼠相比，低蛋白饮食和给予AST-120可降低尿毒症大鼠血清和尿液中硫酸吲哚酚的水平、血尿素氮水平、尿蛋白水平以及肾小球硬化指数。因此，硫酸吲哚酚作为一种循环性尿毒症毒素，在尿毒症模型中促进了肾小球硬化的进展。低蛋白饮食和AST-120可降低血清和尿液中硫酸吲哚酚的水平，并抑制肾小球硬化的进展。
