Klimek D, Kokot F, Wiecek A, Kuczera M
Katedry i Kliniki Nefrologii Sl.AM w Katowicach.
Pol Arch Med Wewn. 1996 Jan;95(1):3-10.
The role of the atrial natriuretic peptide (ANP) in Na and water metabolism is well recognized. Much less known is the physiological importance of ANP in the metabolism of other electrolytes e.g. calcium and magnesium, which are presumably involved in the pathogenesis of active renal stone disease (ARSD). The present study aimed to assess the potential role of ANP in the pathogenesis of ARSD. Two groups of subjects were examined. The first one comprised 30 patients with ARSD (diagnosed according to Smith's criteria) while the second one consisted of 21 healthy subjects. Both groups were studied under bed rest (BR) and water immersion (IW) conditions. The examined groups were not different by age, sex, serum electrolyte profile (Na, Ca, Mg) and urinary excretion of Na, Ca, Mg and oxalic acid. Patients with ARSD showed significantly higher basal level of ANP and a significantly higher response of ANP secretion to IW as normals. In spite of this abnormality, patients with ARSD showed a similar increase in water, Na, Ca, Mg and oxalic acid excretion stimulated by IW as compared with normals. In contrast to healthy subjects, patients with ARSD showed no significant correlation between serum ANP levels and urinary excretion of Na, Ca and Mg. In addition, only patients with ARSD showed a significant positive correlation between serum ANP and urinary excretion of oxalic acid during WI. Results obtained in this study suggest, that ANP may be involved in the pathogenesis of ARSD.
心房利钠肽(ANP)在钠和水代谢中的作用已得到充分认识。而ANP在其他电解质(如钙和镁)代谢中的生理重要性则鲜为人知,这些电解质可能参与了活动性肾结石病(ARSD)的发病机制。本研究旨在评估ANP在ARSD发病机制中的潜在作用。对两组受试者进行了检查。第一组包括30例ARSD患者(根据史密斯标准诊断),第二组由21名健康受试者组成。两组均在卧床休息(BR)和水浸(IW)条件下进行研究。所检查的两组在年龄、性别、血清电解质谱(钠、钙、镁)以及钠、钙、镁和草酸的尿排泄方面无差异。与正常人相比,ARSD患者的ANP基础水平显著更高,且ANP分泌对IW的反应也显著更高。尽管存在这种异常,但与正常人相比,ARSD患者在IW刺激下的水、钠、钙、镁和草酸排泄增加情况相似。与健康受试者不同,ARSD患者的血清ANP水平与钠、钙和镁的尿排泄之间无显著相关性。此外,只有ARSD患者在WI期间血清ANP与草酸的尿排泄之间存在显著正相关。本研究获得的结果表明,ANP可能参与了ARSD的发病机制。