Bagi Zsolt, Hamar Peter, Antus Balazs, Rosivall Laszlo, Koller Akos
Department of Pathophysiology, Semmelweis University, Budapest, Hungary.
Kidney Blood Press Res. 2003;26(1):19-26. doi: 10.1159/000069762.
Chronic renal failure (CRF) is frequently accompanied by systemic vascular alterations which further increase the morbidity and mortality of these patients. However, the nature and the underlying mechanisms of vascular dysfunction are not completely understood. We hypothesized that--in addition to other factors--CRF alters local vasomotor mechanisms that are intrinsic to the vascular wall.
Changes in the diameter of isolated, pressurized (at 80 mm Hg) gracilis skeletal muscle arterioles (diameter approximately 150 microm) of female Wistar rats were investigated by videomicroscopy. Arteriolar responses to an increase in flow and vasoactive agents in partially nephrectomized (NX) and sham-operated (control) rats were compared.
In NX rats, serum creatinine and urine protein excretion were increased. Compared to controls, increases in intraluminal flow (from 0 to 40 microl/min) resulted in significantly reduced dilation in arterioles of NX rats (maximum: 32 +/- 4 vs. 15 +/- 4 microm, p < 0.05). Inhibition of nitric oxide (NO) synthesis with L-NAME reduced the dilation of control arterioles but did not affect responses of NX arterioles. Also, dilations in response to histamine were significantly reduced in arterioles from NX rats as compared to control rats. L-NAME significantly decreased histamine-induced dilations of control arterioles, but it did not affect responses of NX arterioles. Dilations in response to the NO donor sodium nitroprusside were also significantly decreased in NX arterioles as compared to responses of control vessels, whereas responses to adenosine and norepinephrine were not significantly different in the two groups.
We conclude that in rat skeletal muscle arterioles, CRF induced by renal mass reduction alters the mechanosensitive and agonist-induced responses of peripheral arterioles, in part by interfering with NO-signaling mechanisms. These alterations could contribute to increased peripheral vascular resistance and further aggravate the cardiovascular complications in CRF.
慢性肾衰竭(CRF)常伴有全身血管改变,这进一步增加了这些患者的发病率和死亡率。然而,血管功能障碍的本质和潜在机制尚未完全明确。我们推测,除其他因素外,CRF会改变血管壁固有的局部血管舒缩机制。
通过视频显微镜研究雌性Wistar大鼠分离的、加压(80毫米汞柱)的股薄肌骨骼肌小动脉(直径约150微米)直径的变化。比较部分肾切除(NX)大鼠和假手术(对照)大鼠小动脉对流量增加和血管活性药物的反应。
在NX大鼠中,血清肌酐和尿蛋白排泄增加。与对照组相比,管腔内流量增加(从0至40微升/分钟)导致NX大鼠小动脉的扩张显著减少(最大值:32±4对15±4微米,p<0.05)。用L-NAME抑制一氧化氮(NO)合成可减少对照小动脉的扩张,但不影响NX小动脉的反应。此外,与对照大鼠相比,NX大鼠小动脉对组胺的扩张反应显著降低。L-NAME显著降低组胺诱导的对照小动脉扩张,但不影响NX小动脉的反应。与对照血管的反应相比,NX小动脉对NO供体硝普钠的扩张反应也显著降低,而两组对腺苷和去甲肾上腺素的反应无显著差异。
我们得出结论,在大鼠骨骼肌小动脉中,肾质量减少诱导的CRF改变了外周小动脉的机械敏感性和激动剂诱导的反应,部分是通过干扰NO信号机制。这些改变可能导致外周血管阻力增加,并进一步加重CRF的心血管并发症。