Grant-in-Aid for Overseas Scientific Survey.
|Research Institution||Kyorin University School of Medicine|
ENDOU Hitoshi Department of Pharmacology and Toxicology, Kyorin University School of Medicine, 医学部, 教授 (20101115)
VIPADA Chaov ウボン地区病院, 内科学, 医長
WATTANACHAI コンケン地区病院, 内科学, 医長
UDOM Chantha マヒドン大学, 理学部, 助手
CHAIRAK Shay マヒドン大学, 医学部, 助手
SAMAISUKH So マヒドン大学, 理学部, 講師
SOMKIAT Vasu マヒドン大学, 医学部, 助手
PRIDA Malasi マヒドン大学, 医学部, 講師
SUMALEE Nimm マヒドン大学, 医学部, 教授
SAーNGA Nilwa マヒドン大学, 医学部, 教授
村井 善郎 東京都多摩老人医療センター, 血液科, 医長
小松 康宏 東京女子医大, 医学部, 助手 (60195849)
五十嵐 隆 東京大学, 医学部, 講師 (70151256)
千葉 百子 順天堂大学, 医学部, 助教授 (80095819)
稲葉 裕 順天堂大学, 医学部, 教授 (30010094)
SANGA Nilwar マヒドン大学, 医学部, 教授
SUMALEE Nimmannit Department of Medicine, Faculty of Medicine, Siriraj Hospital
SANGA Nilwarangkur Department of Medicine, Faculty of Medicine, Siriraj Hospital
PRIDA Malasit Department of Molecular Biology, Faculty of Medicine Mahidol University
VIPADA Chaovakul Department of Medicine Ubol District Hospital
UDOM Chantharaksri Department of Pharmacology, Faculty of Science, Mahidol University
MURAI Yoshiro Department of Hematology, Tokyo Metropolitan Tama Geriatric Hospital
KOMATSU Yasuhiro Department of Pediatric Nephrology, Tokyo Women's Medical College
CHIBA Momoko Department of Hygiene, Juntendo University School of Medicine
IGARASHI Takashi Department of Pediatrics, Faculty of Medicine The University of Tokyo, Mejirodai
INABA Yutaka Department of Hygiene, Juntendo University School of Medicine
SAMAISUKUH Sophasan Department of Physiology, Faculty of Science, Mahidol University
WATTANACHAI Susaengrat Department of Medicine, Khon Kaen District Hospital
SOMKIAT Vasuvattakul Department of Medicine, Faculty of Medicine, Siriraj Hospital
CHAIRAT Shayakul Department of Medicine, Faculty of Medicine, Siriraj Hospital
|Project Fiscal Year
1992 – 1993
Completed(Fiscal Year 1993)
|Budget Amount *help
¥13,000,000 (Direct Cost : ¥13,000,000)
Fiscal Year 1993 : ¥5,000,000 (Direct Cost : ¥5,000,000)
Fiscal Year 1992 : ¥8,000,000 (Direct Cost : ¥8,000,000)
|Keywords||Distal renal tubular acidosis / North-eastern Thailand / beta2-Microglobulin / Hypokalemia / Hypomagnesemia / Proximal tubule dysfunction / Trace element / Sodium pump / 遠位尿細管性アシドーシス / タイ東北部 / β2ミクログロブリン / 低カリウム血症 / 低マグネシウム血症 / 近位尿細管障害 / 微量元素 / ナトリウムポンプ / β_2ミクログロブリン|
The purpose of this project was to investigate possible causes of endemic renal distal tubular acidosis(EdRTA)in Northeastern part of Thailand. Two ways of trials were carried out, fieldwork and animal model experiments. Results obtained are as follows.
1.Fieldwork : A research center has been settled at the Ubol District Hospital, Ubol Rajathanee, Ubol Prefecture, Thailand. EdRTA patients and healthy volunteers were selected for interview, clinical examinations and clinical biochemical analyses of blood and urine. Materials such as diet, soil, water and agricultural products were also sampled and brought to Japan for analysis of trace elements. Results are as follows.
(1)Most patients were old aged females. They were small in height and light in body weight. Thus, BMI (body weight/hight^2)were low. Their urine gravity decreased.
(2)Urinary beta2-microglobulin contents in EdRTA were significantly increased, and pH was high. Urinary creatinine concentrations decreased.
(3)Urinary vanadium e
xcretion was significantly increased in EdRTA.
(4)Plasma Mg concentrations were high, and K was low in both sexes. Zn concentrations were high in male EdRTA, and Na was low in the female.
2.Animal model with low Mg diet
Mg is an essential substrate especially for ATPases including Na, K-ATPase and H-ATPase, and low Mg sometimes is parallelled with low K. Usually Mg is reabsorbed in the thick ascending limb of Henle's loop(TAL). We, therefore, microdissected TAL and the collecting tubule(CT)from control and low K rat kidneys for Na, K-ATPase assay.
(1)Na, K-ATPase activity in TAL from low Mg rats was significantly lowered.
(2)The enzyme activity in CT was significantly increased. This finding is unexpected, since lowered Na, K-ATPase activity should initiate plasma K increase, resulting in dRTA theoretically. This discrepancy should be further investigated.
3.Analysis of urinary proteins in hypo K rats.
SD rats were treated with low K diet for 3 months, and their urinary proteins were electrophoresed. Total protein excretion was significantly increased. Electrophoretic patterns show increment of not only low molecular proteins but also high molecular proteins. This result is also slightly different from clinical data.
In conclusion, these results clearly suggest that electrolytes and/or trace elements may play important roles in manifestation of EdRTA in Thailand. Less