Alivanis P, Grekas D, Siulis A, Diudis C, Derveniotis V, Vasiliu S, Tourkantonis A
First Medical Department, University Hospital AHEPA, Thessaloniki, Greece.
Ren Fail. 1993;15(1):81-3. doi: 10.3109/08860229309065578.
Studies in experimental models of renal ischemia have shown that calcium antagonists are effective in the protection from the ischemic insult. Thirty-five patients who received a kidney graft over a 2-year period (nifedipine group) were compared with 35 consecutive transplanted patients (control group). The two groups were compatible with regard to age, sex, duration of hemodialysis, graft matching, and total number of blood transfusions. The patients in the nifedipine group were given 0.2 mg nifedipine (10% solution) through the renal artery immediately after revascularization, and also nifedipine per os during all the study periods. Adequate diuresis (1 mL/min) was obtained in 14.5 +/- 37.2 and 43.9 +/- 46.8 h after transplantation in the nifedipine and control groups respectively (p < 0.01). The frequency of acute tubular dysfunction and the mean serum creatinine concentrations were found to be higher in the control group. Fractional excretion of sodium was not found to be different in the two groups on the first day, but it was significantly lower by the first week after transplantation in the nifedipine group (p < 0.05). Acute rejection episodes were found to be more frequent in the control group during the first 6 months after transplantation (p < 0.05). It is suggested that nifedipine is effective in the protection of renal function after transplantation.
对肾缺血实验模型的研究表明，钙拮抗剂在保护肾脏免受缺血性损伤方面是有效的。将在两年内接受肾移植的35例患者（硝苯地平组）与35例连续接受移植的患者（对照组）进行比较。两组在年龄、性别、血液透析时间、移植物匹配和输血总数方面具有可比性。硝苯地平组患者在血管再通后立即通过肾动脉给予0.2 mg硝苯地平（10%溶液），并且在整个研究期间均口服硝苯地平。硝苯地平组和对照组分别在移植后14.5±37.2小时和43.9±46.8小时获得了充足的尿量（1 mL/分钟）（p<0.01）。发现对照组急性肾小管功能障碍的发生率和平均血清肌酐浓度更高。两组在移植后第一天的钠分数排泄没有差异，但在移植后第一周，硝苯地平组的钠分数排泄显著降低（p<0.05）。发现对照组在移植后的前6个月急性排斥反应发作更为频繁（p<0.05）。提示硝苯地平在移植后保护肾功能方面是有效的。
