鱼油和环孢素A致肾移植患者肾灌注不足

Fish oil and cyclosporin A-induced renal hypoperfusion in kidney-transplanted patients.

作者信息

Hansen J M, Høy C E, Strandgaard S

机构信息

Department of Clinical Physiology, Herlev Hospital, University of Copenhagen, Denmark.

出版信息

Nephrol Dial Transplant. 1995;10(9):1745-50.

PMID:8559499

Abstract

BACKGROUND

Dietary supplementation with fish oil has been said to improve renal function in cyclosporin A (CsA)-treated subjects.

METHODS

Renal function and the acute renal haemodynamic and tubular response to an oral CsA-dose (3 mg/kg) were investigated before and after 12 weeks of fish oil supplementation (6 g/day) in 12 low-dose CsA-treated kidney-transplanted patients (s-creatinine, 124 +/- 24 mumol/l, mean +/- SD). After an overnight fast, ten l-h renal clearance periods were performed, two periods before and eight after CsA-ingestion. An additional control clearance study without CsA intake was performed in six subjects.

RESULTS

Fish oil did not change baseline values of the effective renal plasma flow (ERPF) or the glomerular filtration rate (GFR). Compared to the control study, CsA decreased GFR and ERPF significantly on average 20 +/- 3% (P < 0.01) and 23 +/- 3% (P < 0.01) respectively, 4-6 h after peak CsA blood concentration with no additional effect of fish oil. CsA also significantly decreased the renal clearance of lithium, used as an index of proximal tubular outflow, with no impact of dietary fish oil.

CONCLUSION

Fish oil supplementation had no effect on baseline renal function or CsA-induced hypoperfusion in stable renal transplant recipients treated with a low maintenance dose of CsA.

摘要

背景

据说在接受环孢素A（CsA）治疗的患者中，补充鱼油可改善肾功能。

方法

对12例接受低剂量CsA治疗的肾移植患者（血清肌酐，124±24μmol/l，均值±标准差），在补充鱼油（6g/天）12周前后，研究其肾功能以及对口服CsA剂量（3mg/kg）的急性肾血流动力学和肾小管反应。禁食过夜后，进行10个1小时的肾脏清除期，在摄入CsA前进行2个清除期，摄入后进行8个清除期。另外对6名受试者进行了一次不摄入CsA的对照清除研究。

结果

鱼油未改变有效肾血浆流量（ERPF）或肾小球滤过率（GFR）的基线值。与对照研究相比，在CsA血药浓度峰值后4 - 6小时，CsA平均使GFR和ERPF分别显著降低20±3%（P<0.01）和23±3%（P<0.01），鱼油无额外作用。CsA还显著降低了用作近端肾小管流出指标的锂的肾脏清除率，膳食鱼油无影响。