Hvistendahl J J, Pedersen T S, Hvistendahl G M, Djurhuus J C, Frøkiaer J
Institute of Experimental Clinical Research, University of Aarhus, Denmark.
Urol Res. 2001 Oct;29(5):350-8. doi: 10.1007/s002400100209.
Unilateral ureteral obstruction (UUO) is associated with reductions in ipsilateral renal blood flow (RBF) and glomerular filtration rate (GFR) caused by an active preglomerular vasoconstriction, where angiotensin II (ANGII) may be an important mediator. Calcium-channel blockers preferentially dilate preglomerular vessels and abolish the vasoconstrictor actions of ANGII in preglomerular arterioles of the hydronephrotic rat kidney. In this study, we, therefore, examined the effects of the calcium-channel blocker verapamil (3.65 microg/kg per minute i.v.) on RBF, GFR and renal vascular resistance (RVR) in our pig model with UUO, where ultrasonic flow probes are mounted on each renal artery and catheters placed in the abdominal aorta and both renal veins. Verapamil treatment was associated with a 34% reduction in ipsilateral RBF (from 182.6 +/- 20.5 ml/min to 120.6 +/- 12.2 ml/min, P < 0.001), which was similar to the 27% reduction in ipsilateral RBF in controls (from 194.6 +/- 13.1 ml/min to 140.6 +/- 15.2 ml/min, P < 0.001). Ipsilateral GFR was reduced by 70% in the verapamil-treated pigs (from 29.0 +/- 2.6 to 8.5 +/- 0.9 ml/min, P < 0.001) and by 73% in control animals (from 29.2 +/- 3.1 to 7.6 +/- 2.1 ml/min, p < 0.001). However, the increase in RVR was significantly attenuated in the verapamil-treated pigs. Ipsilateral RVR increased by 19% in the verapamil-treated pigs (from 0.585 +/- 0.076 to 0.726 +/- 0.081 mmHg/min/ml, P < 0.05) compared with a 34% increase in control pigs (from 0.560 +/- 0.056 to 0.854 +/- 0.091 mmHg/min per milliliter, P<0.001), suggesting that an intact calcium-channel may be important for the increase in renal vascular resistance during unilateral ureter obstruction. In conclusion, the present study shows that verapamil is able to modulate the increase in renal vascular resistance in response to increased pelvic pressure.
单侧输尿管梗阻(UUO)与由肾前性血管主动收缩引起的同侧肾血流量(RBF)和肾小球滤过率(GFR)降低有关,其中血管紧张素II(ANGII)可能是重要的介质。钙通道阻滞剂优先扩张肾前血管,并消除肾盂积水大鼠肾脏肾前小动脉中ANGII的血管收缩作用。因此,在本研究中,我们在我们的UUO猪模型中检查了钙通道阻滞剂维拉帕米(每分钟静脉注射3.65微克/千克)对RBF、GFR和肾血管阻力(RVR)的影响,在该模型中,超声流量探头安装在每条肾动脉上,导管放置在腹主动脉和两条肾静脉中。维拉帕米治疗使同侧RBF降低了34%(从182.6±20.5毫升/分钟降至120.6±12.2毫升/分钟,P<0.001),这与对照组同侧RBF降低27%(从194.6±13.1毫升/分钟降至140.6±15.2毫升/分钟,P<0.001)相似。在维拉帕米治疗的猪中,同侧GFR降低了70%(从29.0±2.6降至8.5±0.9毫升/分钟,P<0.001),在对照动物中降低了73%(从29.2±3.1降至7.6±2.1毫升/分钟,P<0.001)。然而,在维拉帕米治疗的猪中,RVR的增加显著减弱。与对照猪RVR增加34%(从0.560±0.056升至0.854±0.091毫米汞柱/分钟/毫升,P<0.001)相比,维拉帕米治疗的猪同侧RVR增加了19%(从0.585±0.076升至0.726±0.081毫米汞柱/分钟/毫升,P<0.05),这表明完整的钙通道对于单侧输尿管梗阻期间肾血管阻力的增加可能很重要。总之,本研究表明维拉帕米能够调节因盆腔压力增加而导致的肾血管阻力增加。