Objective To study the effects of low molecular weight heparin ( LMWH) on renal osteodystrophy and vascular calcification in rats with chronic kidney disease (CKD) in comparison with unfractionated heparin (UFH). Methods CKD model with secondary hyperparathyroidism was established by feeding adenine diet to rats. 50 male SD rats were randomly divided into five groups for six weeks' raising: (1) Normal group; (2) CKD group; (3) CKD unfractionated heparin (UFH) group (CKD heparin); (4) CKD low-dose LMWH group (CKD L-LMWH); (5) CKD high-dose LMWH group (CKD H-LMWH). The normal control group was fed with diet without adenine for 6 weeks and the other 4 groups were raised by adenine-containing diet for the first 4 weeks and diet without adenine for the following 2 weeks. Six weeks later, all rats were executed. Calcium and phosphorus contents of were tested using spectrum analysis and bone mineral density ( BMD) and biomechanical parameters were determined at femur and the 5thlumbar vertebra. Results There were no statistical differences on vascular calcium or phosphorus content between the CKD group, CKD heparin group, CKD L-LMWH group and CKD H-LMWH group. Compared with the CKD group, femur total and trabecular BMD and lumbar BMD were significantly lower in the CKD heparin group, but there were no significant differences between the CKD group, CKD L-LMWH group and CKD H-LMWH group in femur total and trabecular BMD and lumbar BMD. No significant differences were found in femur cortical BMD between the CKD group, CKD heparin group, CKD L-LMWH group and CKD H-LMWH group. In the lumbar compression test, the structural and material biomechanical parameters (maximum load, stiffness, maximum stress and elastic modulus) were significantly reduced in the CKD heparin group compared with the CKD group, and there were no significant differences between the CKD group, CKD L-LMWH group and CKD H-LMWH group on these lumbar biomechanical parameters. In the three-point bending test, no significant differences were found between the CKD group, CKD heparin group, CKD L-LMWH group and CKD H-LMWH group on the structural and material biomechanical parameters (maximum load, stiffness, maximum stress and elastic modulus). Conclusion LMWH had no effect on BMD and biomechanical parameters of trabecular bone in CKD rats with secondary hyperparathyroidism, and UFH could reduce BMD and biomechanical properties of trabecular bone in CKD rats with secondary hyperparathyroidism. Both LMWH and UFH had no significant effect on BMD and biomechanical parameters of cortical bone in CKD rats with secondary hyperparathyroidism. Both LMWH and UFH had no effect on vascular calcification in CKD rats with secondary hyperparathyroidism.%目的 用腺嘌呤诱导的慢性肾脏病( chronic kidney disease, CKD)大鼠模型观察低分子肝素( low molecular weight heparin,LMWH)对CKD时肾性骨病和血管钙化的影响,与普通肝素(unfractionated heparin,UFH)进行比较.方法 50只雄性SD大鼠随机分为正常对照组、CKD组、CKD普通肝素组( CKD Heparin)、慢性肾脏病低剂量LMWH组( CKD L-LMWH)、慢性肾脏病高剂量LMWH组(CKD H-LMWH)5组.第6周末处死大鼠,行主动脉血管钙磷含量测定,取股骨和第5腰椎做骨密度(bone mineral density,BMD)检查、腰椎压缩试验、三点弯曲试验.结果 与CKD组比较,CKD Heparin组、CKD L-LMWH组、CKD H-LMWH组血管钙磷水平没有统计学差异.与CKD组比较,CKD Heparin组的股骨总BMD、股骨松质骨BMD和腰椎BMD均明显降低,而CKD L-LMWH组和CKD H-LMWH组与CKD组比较上述参数无明显差异.与CKD组比较,CKD Heparin组、CKD L-LMWH组和CKD H-LMWH组的股骨皮质骨BMD无明显差异.腰椎压缩试验,与CKD组比较,CKD Heparin组的结构力学和材料力学参数明显降低,CKD L-LMWH组和CKD H-LMWH组分别与CKD组比较上述力学参数无差异.三点弯曲试验,与CKD组比较,CKD Heparin、CKD L-LMWH组或CKD H-LMWH组力学参数均无差异.结论 LMWH对有继发性甲旁亢的CKD大鼠的松质骨BMD和骨力学参数无影响,而UFH可以降低松质骨的BMD和骨力学性能;LMWH和UFH对有继发性甲旁亢的CKD大鼠的皮质骨BMD和骨力学性能无影响. LMWH和UFH对有继发性甲旁亢的CKD大鼠的血管钙化无影响.
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