水腎症患者の尿中 Mg 排泄に関する研究

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Magnesium concentration in serum was significantly lower in patients with bilateral hydronephrosis (1.52±0.15mEq/1, mean±S.D.)than in 74 healthy adults (1.82±0.17 mEq/1)and 10 normal control subjects(1.65±0.15mEq/1)(p<0.05). There was no correlation between serum magnesium concentration and GFR. In regard to magnesium clearance (C_<Mg>)under water dieresis there existed no significant difference between patients with bilateral hydronepherosis and normal control subjects. No significant reduction of C_<Mg> was observed in hydronephrotic patients with lowered GFR. Excretion fraction of filtered magnesium (EF_<Mg>)in patients with bilateral hydronephrosis (13.58±9.76%)was significantly higher than that of normal control subjects(4.54±1.75%)(P<0.01), and tended to be higher as GFR became lower. Between EF_<Mg> and excretion fraction of filtered sodium (EF_<Na>)in patients with bilateral hydronephrosis, a high correlation was noted: the regression line being EF_<Mg>=2.52×EF_<Na>+2.61(γ=0.786, p<0.01).Whereas no correlation was seen between EF_<Mg> and excretion fraction of filtered calcium. In 4 patients with unilateral hydronephrosis who underwent individual renal function test, EF_<Mg> of the hydronephrotic kidney was higher than that of the contra lateral normal kidney. On the other hand, in 3 patients with unilateral renal arterial stenosis, EF_<Mg> of the steno tic kidney was lower than that of the normal kidney on the opposite side. EF_<Mg> observed in 4 patients with primary aldosteronism and in 3 patients with primary hyperparathyroidism showed no significant difference from that of normal control subjects. EF_<Mg> estimated in 4 patients with unilateral hydronephrosis during infusion of Mg-aspartame and furosemide demonstrated a very sharp increase in both hydronephrotic and normal kidneys, and the difference between the two kidneys was reduced. The above-mentioned results indicate that there is a tendency of renal wasting of magnesium in hydronephrosis probably due to disturbances in magnesium reabsorption in the renal tubules.
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水腎症患者の尿中 Mg 排泄に関する研究

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