Upregulation of serum retinol in experimental acute renal failure.

Serum vitamin A homeostasis was studied in rats with nonfiltering kidneys prepared by ligation of renal arteries. Within 1-2 h of acute renal failure, the serum retinol level increased by 11-73% and was maintained for at least 4 h. More than 90% of the increase in serum retinol was associated with retinol in the retinol binding protein-transthyretin (RBP-TTR) complex. The activities of acyl-CoA:retinol acyltransferase and retinyl-palmitate hydrolase were not altered by short-term acute renal failure. Oral administration of 3H-labeled retinol 3 h before surgery resulted in 350% more tritium in the serum retinol-RBP-TTR complex of rats with acute renal failure as compared to sham-operated rats; this increase represented the fraction of retinol in RBP-TTR contributed by hepatic retinol from newly absorbed 3H-labeled retinol. Total retinol in the retinol-RBP-TTR complex was increased by only 60%. We conclude that short-term acute renal failure causes rapid upregulation of serum retinol-RBP-TTR; the extent of the increase depends on the magnitude of hepatic vitamin A stores, particularly the retinol pools. We hypothesize that kidney modulates the regulation of hepatic release of retinol-RBP from the pool of newly acquired retinol.