Golin R, Genovesi S, Castoldi G, Wijnmaalen P, Protasoni G, Zanchetti A, Stella A
Istituto di Clinica Medica Generale e Terapia Medica, University of Milan, Ospedale Maggiore, Italy.
Arch Ital Biol. 1999 Aug;137(4):289-97.
The relationship between renal perfusion pressure and urinary sodium is involved in arterial pressure regulation. The aim of this study was to investigate the role of renal nerves and angiotensin II in the pressure-natriuresis relationship. Experiments were performed in anaesthetised cats in which one kidney was surgically denervated. Renal perfusion pressure (RPP), renal blood flow (RBF) glomerular filtration rate (GFR, creatinine clearance), urinary volume (V) and sodium excretion (Una + V) were separately measured from both kidneys. RPP was progressively reduced in two consecutive steps by a suprarenal aortic snare. Two groups of animals were studied: the first without any pharmacological treatment (Untreated), the second during treatment with an angiotensin converting enzyme inhibitor (Captopril, 0.4 mg/Kg intravenously followed by an infusion of 0.4 mg/Kg/h). In the Untreated group RPP was reduced from 152.4 +/- 7.3 to 113.6 +/- 5.8 and 83.0 +/- 4.4 mmHg during the first and second step respectively. RBF and GFR were only slightly reduced during the second step of reduced RPP. In control conditions V and UNa + V were greater in the denervated compared to the innervated kidney. The graded decrease in RPP reduced both V and UNa + V in the innervated as well as in the denervated kidney. In the Captopril group V and UNa + V were larger than in the Untreated group in both the innervated and the denervated kidney. A decrease of RPP similar to that observed in the Untreated group, produced similar haemodynamic changes. Also in the Captopril group the graded decrease in RPP reduced both V and UNa + V in the innervated as well as in the denervated kidney. Matching UNa + V against RPP values significant correlations were found in the innervated and denervated kidneys of both groups. Both renal denervation and ACE inhibition were accompanied by an increased gain of the pressure-natriuresis curve, but only renal denervation shifted the crossing of the pressure axis to the left. In the ACE inhibited animals renal denervation only shifted the curve to the left. In conclusion our data suggest that i) at each level of RPP renal nerves and angiotensin II decrease renal sodium excretion, ii) renal nerves and angiotensin II increase the slope of the renal function curve, iii) renal nerves shift to the right the renal function curve.
肾灌注压与尿钠之间的关系参与动脉血压调节。本研究的目的是探讨肾神经和血管紧张素II在压力-利钠关系中的作用。实验在麻醉猫身上进行,其中一侧肾脏通过手术去神经支配。分别测量两侧肾脏的肾灌注压(RPP)、肾血流量(RBF)、肾小球滤过率(GFR,肌酐清除率)、尿量(V)和钠排泄量(Una + V)。通过肾上腹主动脉圈套器分两步逐渐降低RPP。研究了两组动物:第一组未进行任何药物治疗(未治疗组),第二组在使用血管紧张素转换酶抑制剂(卡托普利,静脉注射0.4mg/kg,随后以0.4mg/kg/h的速度输注)治疗期间。在未治疗组中,RPP在第一步和第二步分别从152.4±7.3降至113.6±5.8和83.0±4.4mmHg。在RPP降低的第二步,RBF和GFR仅略有降低。在对照条件下,去神经支配的肾脏的V和UNa + V比有神经支配的肾脏更大。RPP的分级降低使有神经支配和去神经支配的肾脏的V和UNa + V均降低。在卡托普利组中,有神经支配和去神经支配的肾脏的V和UNa + V均大于未治疗组。与未治疗组观察到类似的RPP降低,产生了类似的血流动力学变化。在卡托普利组中,RPP的分级降低也使有神经支配和去神经支配的肾脏的V和UNa + V均降低。将UNa + V与RPP值匹配,在两组有神经支配和去神经支配的肾脏中均发现显著相关性。肾去神经支配和ACE抑制均伴随着压力-利钠曲线增益增加,但只有肾去神经支配使压力轴的交叉点向左移动。在ACE抑制的动物中,肾去神经支配仅使曲线向左移动。总之,我们的数据表明:i)在每个RPP水平,肾神经和血管紧张素II均降低肾钠排泄;ii)肾神经和血管紧张素II增加肾功能曲线的斜率;iii)肾神经使肾功能曲线向右移动。