[Growth and protein metabolism in chronic metabolic acidosis from experimental renal insufficiency].

Annales de pediatrie Pub Date : 1993-02-01
S Maniar, A Caldas, D Laouari, C Kleinknecht
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Abstract

Two studies of uremia-induced chronic metabolic acidosis (CMA) were carried out to determine: 1) the level of acidosis beyond which growth failure occurs; 2) the protein metabolism anomalies which are associated with growth failure. Rats rendered uremic by subtotal nephrectomy were fed a diet containing sufficient protein amounts (30% casein) to induce CMA. CMA was left uncorrected in half the rats (group A) and was corrected by administration of bicarbonate in the other half (group B). 1) Fifty-two group A rats were compared with 52 group B rats matched for renal function. Results showed that a) CMA failed to reduce food intake; b) weight gain decreased only when CMA was profound (pH < 7.20) whereas reductions in length gain occurred at less severe levels of acidosis (pH < 7.25) suggesting that bone may be more susceptible to CMA than muscle mass. 2) Protein fractional synthesis rate was evaluated in skeletal muscle after a flooding dose of 3H-phenylalanine in group A rats (pH 7.22 +/- 0.01, HCO3-: 15.2 +/- 0.8 mmol/l) and group B rats matched for renal function. Values were identical in both groups (10.4 +/- 0.5 vs 10.8 +/- 0.5%/day). However, fractional muscle protein accretion rate was decreased in group A rats. These data demonstrate that CMA-associated growth failure in uremia is due to increased breakdown of protein with no change in protein production.

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[实验性肾功能不全慢性代谢性酸中毒的生长与蛋白质代谢]。
我们对尿毒症引起的慢性代谢性酸中毒(CMA)进行了两项研究,以确定:1)超过生长衰竭的酸中毒水平;2)与生长衰竭相关的蛋白质代谢异常。用含有足够蛋白质(30%酪蛋白)的日粮诱导肾大部切除后出现尿毒症的大鼠。一半大鼠(A组)不纠正CMA,另一半大鼠(B组)给予碳酸氢盐纠正CMA。1)将52只A组大鼠与52只肾功能匹配的B组大鼠进行比较。结果表明:a) CMA不能减少摄食量;b)只有当CMA严重(pH < 7.20)时,体重增加才会减少,而在酸中毒程度较轻(pH < 7.25)时,体重增加会减少,这表明骨骼可能比肌肉质量更容易受到CMA的影响。2)评价3h -苯丙氨酸水浸剂量后a组(pH 7.22 +/- 0.01, HCO3-: 15.2 +/- 0.8 mmol/l)和肾功能匹配的B组大鼠骨骼肌蛋白质分级合成率。两组的数值相同(10.4 +/- 0.5 vs 10.8 +/- 0.5%/天)。然而,A组大鼠的肌肉蛋白分数增加率降低。这些数据表明,尿毒症中cma相关的生长衰竭是由于蛋白质分解增加而蛋白质产量没有变化。
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