Hvistendahl Jan J, Pedersen Thomas S, Djurhuus Jens C, Pedersen Erling B, Frøkiaer Jørgen
Institute of Experimental Clinical Research, University of Aarhus, Aarhus University Hospital-Skejby, 8200 Aarhus N, Denmark.
Urol Res. 2002 Jul;30(3):169-77. doi: 10.1007/s00240-002-0240-y. Epub 2002 May 24.
Unilateral ureteral obstruction in pigs is associated with an enhanced, de novo generation of angiotensin II from the ipsilateral kidney. In order to further investigate the role of this system during unilateral ureter obstruction, the renal hemodynamic response to the non-peptide angiotensin II antagonist losartan was investigated. Danish land race pigs were operated on under general anesthesia. Catheters were placed in both renal veins by x-ray and ultrasonic flow probes were mounted on the renal arteries. Losartan (2 mg/kg/h) was administered intravenously to an experimental group ( n=9) continuously over 8 h of unilateral ureteral occlusion. This group was then compared to a matched control group which received only saline ( n=6). Ipsilateral pelvic pressure, renal blood flow using ultrasound transit time, glomerular filtration rate, mean arterial pressure and heart rate were measured. Renal handling of angiotensin II was examined by determining the renal extraction and secretion rates of immunoreactive angiotensin II. The anticipated reduction in ipsilateral renal blood flow after the onset of obstruction was attenuated in the losartan treated pigs, but the ipsilateral glomerular filtration rate was unaffected as compared with the controls. In the losartan group, the increase in renal vascular resistance was significantly reduced compared with un-treated controls (141+/-25% vs 217+/-24%, P<0.05). Plasma immunoreactive angiotensin II increased significantly from all three sample locations in both groups after the onset of obstruction, being more pronounced in the losartan treated group in which immunoreactive angiotensin II from the ipsilateral renal vein increased from 5.1+/-0.5 pmol/l to 41.6+/-19.6 pmol/l, P=0.027. In the controls immunoreactive angiotensin II increased from 2.7+/-0.3 pmol/l to 24.8+/-10.2 pmol/l. Furthermore, plasma aldosterone was significantly reduced after losartan administration (from 80.4 pmol/l to 36.0 pmol/l, P=0.005), indicating effective blockade of the angiotensin II type-1 receptor. The results from the present study suggest that continuous intravenous administration of losartan blocks the angiotensin II receptor mediated effects in the pig. Losartan is able to reduce ipsilateral vasoconstriction in the obstructed kidney during unilateral ureter obstruction supporting the view that angiotensin II is an important mediator of vasoconstriction during unilateral ureter obstruction in the pig model with acute unilateral occlusion of the ureter.
猪的单侧输尿管梗阻与同侧肾脏中血管紧张素II的增强、从头生成有关。为了进一步研究该系统在单侧输尿管梗阻期间的作用,研究了非肽类血管紧张素II拮抗剂氯沙坦对肾脏血流动力学的影响。丹麦长白猪在全身麻醉下接受手术。通过X射线将导管置于双侧肾静脉中,并将超声血流探头安装在肾动脉上。在单侧输尿管梗阻的8小时内,向实验组(n = 9)持续静脉注射氯沙坦(2 mg/kg/h)。然后将该组与仅接受生理盐水的匹配对照组(n = 6)进行比较。测量同侧肾盂压力、使用超声通过时间测量的肾血流量、肾小球滤过率、平均动脉压和心率。通过测定免疫反应性血管紧张素II的肾脏摄取和分泌率来检查肾脏对血管紧张素II的处理。在氯沙坦治疗的猪中,梗阻开始后同侧肾血流量的预期减少有所减轻,但与对照组相比,同侧肾小球滤过率未受影响。在氯沙坦组中,与未治疗的对照组相比,肾血管阻力的增加显著降低(141±25%对217±24%,P<0.05)。梗阻开始后,两组所有三个采样部位的血浆免疫反应性血管紧张素II均显著增加,在氯沙坦治疗组中更为明显,其中同侧肾静脉的免疫反应性血管紧张素II从5.1±0.5 pmol/l增加到41.6±19.6 pmol/l,P = 0.027。在对照组中,免疫反应性血管紧张素II从2.7±0.3 pmol/l增加到24.8±10.2 pmol/l。此外,氯沙坦给药后血浆醛固酮显著降低(从80.4 pmol/l降至36.0 pmol/l,P = 0.005),表明血管紧张素II 1型受体被有效阻断。本研究结果表明,持续静脉注射氯沙坦可阻断猪体内血管紧张素II受体介导的作用。在单侧输尿管梗阻期间,氯沙坦能够减轻梗阻肾脏的同侧血管收缩,支持血管紧张素II是猪急性单侧输尿管梗阻模型中血管收缩的重要介质这一观点。