Korean Journal of Nephrology 1991;10(4):534-544.

실험적 허혈성 급성 신부전에서 칼슘 길항제의 투여가 신기능과 혈장 Renin 활성도에 미치는 영향

최원충 , 차대룡 , 권영주 , 조원용 , 김형규

Abstract

In the process of ischemic cell injury, alterations in one such variable, that of cellular calcium homeostasis, appear to be of major significance. Probably calcium entry blockers could protect against, attenuate the degree of, or enhance recovery from, renal ischemic injury by several mechanisms. And the renin-angiotensin system may play a central role in the pathogeneisis of acute renal failure (ARF). The evidence that cytosolic Ca" is an inhibitory second messenger in renin secretion has been reviewed recently. Therefore the purpose of this study was to evaluate the effect of systemic calcium entry blockers pretreat- ment on renal function & plasma renin activity (PRA) in the experimental ischemic ARF model. Ten cats were anesthesized with pentobarbital sodium (40 mg/kg, I.M) and a tracheostomy, two IV line and a urinary catheter were placed in position. Temperature was maintained at 37.5C. By an abdominal approach, both renal arteries were isolated. Five cats were used as controls and received saline for 2 hours before bilateral renal artery clamp. Another five cats were treated with nifedipine (10 mg/kg) subcutaneously 2 hours before bilateral renal artery clamp. All ten cats underwent 1 hour of renal artery clamp followed by 3 hours of reperfusion and hydration with saline. Before clamp and after reperfusion, blood and urine were sampled for creatinine, Na, p2-microglobulin, PRA and urine vol- ume was measured. The results were as follows: In the control group, the Ccr value was 125.5±151.6ml/min/kg before clamp decreased to 6.2±5.3ml/min/kg after reperfusion; in the experimental group, the Ccr value was 43.9±48.1 ml/min/kg before clamp and decreased 5.6±5.9ml/ min/kg after reperfusion (p<0.05). And creatinine clearance decreased in experimental group (88.9±7. 9%) compared with control group (89.7±11.1%), these results were not significant statistically (p>0.05). In the control group the PRA value was 14.9±9.2ng/ml/ hr before clamp and decreased 14.0±10.1ng/ml/hr after reperfusion; in the experimental group the PRA value was 11.5±6.9ng/ml/hr before clamp and de- creased 10.3±3.7 ng/ml/hr after reperfusion (p>0.05). From these data, it was suggested that sytemic nifedipine pretreatment exerts the unsignificant protec- tive effect on ARF and influence on the decrement value of PRA unsignificantly.