Kiersztejn M, Wiecek A, Kokot F, Schmidt-Gayk H, Wystrychowski A, Kuczera M
Klinika Nefrologii, Endokrynologii i Chorób Przemiany Materii Slaskiej Akademii Medycznej w Katowicach.
Pol Arch Med Wewn. 1998 Apr;99(4):281-6.
Functionally significant, unilateral renal artery stenosis is characterized by reduced renal perfusion and lateralization of both excretory and endocrine function. The present study aimed to assess the influence of unilateral renal artery stenosis on plasma 1,25-dihydroxyvitamin D3 level. In sixteen patients (10 males and 6 females) with unilateral renovascular hypertension blood samples for estimation of plasma renin activity (PRA) and 1,25-dihydroxyvitamin D3 concentration were withdrawn from the renal vein of the ischaemic and normal kidney, from the femoral artery and from the vena cava inferior distally to the orifices of renal veins. Significantly elevated PRA (20.1 +/- 4.52 ng/ml/h vs 6.0 +/- 1.76 ng/ml/h, p < 0.005) but significantly reduced level of 1,25-dihydroxyvitamin D3 (99.25 +/- 4.8 pmol/l vs 115.75 +/- 6.7 pmol/l, p < 0.05) were found in renal vein blood of the ischaemic kidney as compared with the respective values of the normal kidney. No significant correlation was found between PRA and 1.25-dihydroxyvitamin D3 irrespective of the site of blood withdrawal.
Renal ischaemia seems to exert a suppressive effect on 1,25-dihydroxyvitamin D3 synthesis by the kidney.
具有功能意义的单侧肾动脉狭窄的特征是肾灌注减少以及排泄和内分泌功能的单侧化。本研究旨在评估单侧肾动脉狭窄对血浆1,25 - 二羟维生素D3水平的影响。在16例(10例男性和6例女性)单侧肾血管性高血压患者中,从缺血肾和正常肾的肾静脉、股动脉以及肾静脉开口远端的下腔静脉采集血样,以测定血浆肾素活性(PRA)和1,25 - 二羟维生素D3浓度。与正常肾的相应值相比,缺血肾肾静脉血中的PRA显著升高(20.1±4.52 ng/ml/h对6.0±1.76 ng/ml/h,p<0.005),但1,25 - 二羟维生素D3水平显著降低(99.25±4.8 pmol/l对115.75±6.7 pmol/l,p<0.05)。无论采血部位如何,PRA与1,25 - 二羟维生素D3之间均未发现显著相关性。
肾缺血似乎对肾脏合成1,25 - 二羟维生素D3具有抑制作用。