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实验性少尿型和非少尿型急性肾衰竭中的肾小球改变

Glomerular alterations in experimental oliguric and nonoliguric acute renal failure.

作者信息

Kato A, Hishida A, Kobayashi S, Honda N

机构信息

First Department of Medicine, Hamamatsu University School of Medicine, Japan.

出版信息

Ren Fail. 1993;15(2):215-24. doi: 10.3109/08860229309046155.

Abstract

Studies were performed in oliguric and nonoliguric forms of uranyl acetate (UA)-induced and ischemic acute renal failure (ARF) to examine whether a reduction in GFR is correlated with glomerular morphologic alterations. UA-induced nonoliguric and oliguric ARF were induced in rabbits by i.v. injections of 0.9 and 2 mg/kg, respectively. A 60-min renal artery clamping produced nonoliguric ARF in previously uninephrectomized rats, but oliguric ARF in the clamped kidneys of sham-nephrectomized animals. A decline in the whole-kidney CIn rate was more marked in oliguric ARF kidneys of both models than in nonoliguric ARF kidneys. Also, tubular damage was more pronounced in oliguric kidneys when compared with nonoliguric kidneys. Scanning electron microscopic observations revealed glomerular alterations in oliguric and nonoliguric kidneys in both models, evidenced by a flattening and spreading of podocyte cell bodies associated with loss of epithelial foot processes and a reduction in the density and diameter of endothelial fenestrae. There was no significant difference in these glomerular changes between oliguric and nonoliguric kidneys. The findings suggest that less reduction in the whole-kidney GFR in nonoliguric ARF kidneys is ascribed largely to less pronounced tubular damage rather than to less severe glomerular morphologic alterations.

摘要

研究在醋酸铀酰(UA)诱导的少尿型和非少尿型以及缺血性急性肾衰竭(ARF)中进行,以检查肾小球滤过率(GFR)的降低是否与肾小球形态学改变相关。分别通过静脉注射0.9和2mg/kg醋酸铀酰在兔中诱导出非少尿型和少尿型UA诱导的急性肾衰竭。在先前已切除一侧肾脏的大鼠中,60分钟的肾动脉夹闭产生非少尿型急性肾衰竭,但在假肾切除动物的夹闭肾脏中产生少尿型急性肾衰竭。在两种模型的少尿型急性肾衰竭肾脏中,全肾肌酐清除率(CIn)的下降比非少尿型急性肾衰竭肾脏中更明显。此外,与非少尿型肾脏相比,少尿型肾脏中的肾小管损伤更明显。扫描电子显微镜观察显示,两种模型的少尿型和非少尿型肾脏中均存在肾小球改变,表现为足细胞胞体变平并扩散,伴有上皮足突消失以及内皮窗孔密度和直径降低。少尿型和非少尿型肾脏之间的这些肾小球变化无显著差异。这些发现表明,非少尿型急性肾衰竭肾脏中全肾GFR降低较少主要归因于肾小管损伤较轻,而非肾小球形态学改变较轻。

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