Renal function and renotropic effects of secretin in cystic fibrosis.
In ten cystic fibrosis patients and nine age-matched controls, renal function was determined before and after infusion of secretin. Under baseline conditions creatinine excretion and clearance were significantly elevated, exclusively due to those patients who were homozygous for the DF508 mutation (153 vs 132 ml/min*1.73m2), whereas the glomerular filtration rate, measured by inulin clearance showed no difference. Renal plasma flow and the fractional reabsorption rates of electrolytes were similar in patients and controls. During secretin infusion renal plasma flow increased and the fractional reabsorption rates of electrolytes decreased in both groups. The patients had a increased metabolic clearance (2900 vs 1660 ml/min*m2) and endogenous production rate (9,9 vs 2,5 pmol/min*m2) of of secretin. In conclusion global renal function and electrolyte handling, in particular chloride permeability, are unchanged in cystic fibrosis. Individuals expressing the DF508 genotype showed a selective elevation of creatinine excretion and clearance. The secretion and metabolic clearance of secretin are increased in cystic fibrosis.
Windstetter
D
D
Department of Neonatology, Universitätsklinikum Charité der Humboldt Universität Schumannstr. 20/21 Berlin D-10098 Germany +49 30/2802 5650 +49 30/2802 5824.
Schaefer
F
F
Schärer
K
K
Reiter
K
K
Eife
R
R
Harms
H K
HK
Bertele-Harms
R
R
Fiedler
F
F
Tsui
L C
LC
Reitmeir
P
P
Horster
M
M
Hadorn
H B
HB
D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D003404:Creatinine; D003550:Cystic Fibrosis / Q000235:genetics / Q000503:physiopathology*; D019005:Cystic Fibrosis Transmembrane Conductance Regulator / Q000235:genetics; D004573:Electrolytes / Q000378:metabolism; D005838:Genotype; D005919:Glomerular Filtration Rate; D006801:Humans; D007444:Inulin; D007668:Kidney / Q000187:drug effects / Q000503:physiopathology*; D007677:Kidney Function Tests; D008297:Male; D009154:Mutation; D017595:Renal Plasma Flow / Q000187:drug effects; D012633:Secretin / Q000008:administration & dosage / Q000502:physiology; D010130:p-Aminohippuric Acid
C505032:CFTR protein, human; D004573:Electrolytes; D019005:Cystic Fibrosis Transmembrane Conductance Regulator; D012633:Secretin; D007444:Inulin; D003404:Creatinine; D010130:p-Aminohippuric Acid