Weekes S R, Madden A C, Bergström G, Anderson W P, Evans R G
Department of Physiology, Monash University, Clayton, Vic., Australia.
Kidney Blood Press Res. 2000;23(6):366-75. doi: 10.1159/000025985.
To determine how endothelins affect regional kidney blood flow and responses to increased renal artery pressure (RAP), an extracorporeal circuit was established to control RAP independent of the mean systemic arterial pressure (MAP). RAP was first set at approximately 65 mm Hg, and endothelin-1 (1 ng/kg/min for 30 min then 0.4 ng/kg/min) or vehicle was infused into the renal artery, or the ET(A)/ET(B) antagonist TAK-044 (3 mg/kg plus 3 mg/kg/h) or vehicle was administered intravenously. RAP was then progressively increased in steps from approximately 65 to approximately 160 mm Hg. When RAP was approximately 65 mm Hg, endothelin-1 increased renal vascular resistance (RVR, 72%), and reduced cortical (CBF, 26%) but not medullary blood flow (MBF). TAK-044 reduced MAP (12%) and RVR (15%) and increased CBF (21%) but not MBF. When RAP was increased, renal blood flow (RBF), glomerular filtration rate, and urine and sodium excretion increased, while MAP fell. These responses were unaffected by endothelin-1. TAK-044 potentiated the increases in RBF and reductions in MAP in response to increased RAP, but did not affect urine and sodium excretion. Plasma renin activity was reduced by endothelin-1 and increased by TAK-044. Thus, both exogenous and endogenous endothelins reduce CBF but not MBF, and reduce plasma renin activity, but neither affect pressure natriuresis.
为了确定内皮素如何影响肾脏局部血流以及对肾动脉压(RAP)升高的反应,建立了一个体外循环装置,以独立于平均体动脉压(MAP)来控制RAP。首先将RAP设定在约65 mmHg,然后将内皮素-1(1 ng/kg/min持续30分钟,然后为0.4 ng/kg/min)或赋形剂注入肾动脉,或者静脉注射ET(A)/ET(B)拮抗剂TAK-044(3 mg/kg加3 mg/kg/h)或赋形剂。然后将RAP逐步从约65 mmHg升高至约160 mmHg。当RAP约为65 mmHg时,内皮素-1增加肾血管阻力(RVR,72%),降低皮质血流(CBF,26%),但不影响髓质血流(MBF)。TAK-044降低MAP(12%)和RVR(15%),增加CBF(21%),但不影响MBF。当RAP升高时,肾血流量(RBF)、肾小球滤过率以及尿液和钠排泄增加,而MAP下降。这些反应不受内皮素-1影响。TAK-044增强了因RAP升高而引起的RBF增加和MAP降低,但不影响尿液和钠排泄。内皮素-1降低血浆肾素活性,而TAK-044使其升高。因此,外源性和内源性内皮素均降低CBF但不影响MBF,降低血浆肾素活性,但均不影响压力性利钠作用。