短腸症對於大鼠其尿液與血液中結石參數的影響
曾一修1、馬明傑2
1亞東醫院 外科部 泌尿科；2輔仁大學 醫學系
The influence of short bowel syndrome on stone-related parameters of urine and plasma in adult rats
Yi-Shiou Tseng1, Ming-Chieh Ma2
1Division of Urology, Department of Surgery, Far Eastern Memorial Hospital, New Taipei, Taiwan; 2School of Medicine, Fu Jen Catholic University, New Taipei, Taiwan
Purpose: Short bowel syndrome increases risk for developing renal stones. The study aims to find the influence of short bowel syndrome on the stone-related parameters of plasma and urine in adult male rats.
Materials and Methods: Adult male rats were divided into four groups with 6 rats in each. All groups were fed standard chow and restricted daily amount of drinking water for 28 days. Group 1 received sham operation and D2O drinking water. Group 2 received sham operation and D2O drinking water containing 0.75% Ethylene glycol (EG). Group 3 received 80% small bowel resection (SB) and D2O drinking water. Group 4 received 80% small bowel resection and D2O drinking water containing 0.75% Ethylene glycol. The blood, 24-hour urine and kidneys were harvested in 28th day.
Results: The body weight and food intake were lower in group 4 (SB+EG) than in group 2 (Sham+EG). The amount of 24-hour urine and feces were the same between each group. The calcium and oxalate in urine and plasma were not higher in group 4 (SB+EG) than group 2 (Sham+EG). The urinary magnesium and citrate were not decreased significantly in group 4 (SB+EG) than group 2 (Sham+EG) in 28th day, but significant low urinary citrate was found in SB than Sham groups in 1st day. The AP(CaOx) index did not reach significant difference between group 2 (Sham+EG) and 4 (SB+EG). The urinary osmolarity was lower in in group 4 (SB+EG) than group 2 (Sham+EG). However the ratio of kidney and body weight was higher in group 4 (SB+EG) than group 2 (Sham+EG) that indicated more stone formation in rats with short bowel syndrome.
Conclusions: Our study found that hyperoxaluria was not the only reason for increased kidney stones in rats with short bowel syndrome. Regulation of citrate may play an important role in kidney stone formation of short bowel syndrome.