Conte G, Romano G, Sepe V, De Nicola L, Sabbatini M, Russo D, Memoli B, Ungaro B, Fuiano G, Caglioti A
Department of Nephrology, First Faculty of Medicine, University of Naples, Italy.
Kidney Int. 1992 Sep;42(3):673-80. doi: 10.1038/ki.1992.334.
We investigated the role of atrial natriuretic factor (ANF) in the down-regulation of sodium excretion (UNaV). Seven subjects were sequentially studied while ingesting a normal-salt diet (220 mmol NaCl/day, NSD), a very low-salt diet (20 mmol NaCl/day, VLSD) for six days, and again at NSD for nine days. After one day of VLSD, a negative salt balance of 85 mmol was achieved and plasma ANF decreased from 19.1 (SE 2.5) to 7.2 (SE 2.1) pg/ml, whereas plasma renin activity (PRA) and plasma aldosterone (ALD) increased after the third and second day, respectively. During restoration of volemia (NSD), ANF increased after the third day; in contrast, PRA and ALD decreased earlier. Seven other subjects kept at low-salt diet (50 mmol NaCl/day) were studied during ANF infusion (at 2, 4, 8 ng/min/kg body wt). Increases of ANF from 10.3 (SE 0.9) pg/ml (basal condition) to levels of 24.0 (SE 1.9) pg/ml (infusion study), occurring physiologically in the same subjects after NSD, evoked increases in UNa V that accounted for 62% of UNa V rise necessary to balance the NSD, whereas PRA or ALD did not change. Plasma ANF, unlike PRA or ALD, was directly correlated with UNa V.
(a) ANF changes earlier than PRA and plasma aldosterone during VLSD; (b) PRA and ALD respond more promptly than ANF in the recovery from hypovolemia; (c) during ingestion of a low-salt diet, changes in plasma ANF by infusion account for more than half the increase in UNa V following the shift from low- to normal-salt diet independently of alterations in PRA and ALD.
我们研究了心房利钠因子(ANF)在钠排泄(UNaV)下调中的作用。对7名受试者进行了连续研究,他们依次摄入正常盐饮食(220 mmol氯化钠/天,NSD)、极低盐饮食(20 mmol氯化钠/天,VLSD)6天,然后再次摄入NSD 9天。在VLSD一天后,实现了85 mmol的负盐平衡,血浆ANF从19.1(标准误2.5)降至7.2(标准误2.1)pg/ml,而血浆肾素活性(PRA)和血浆醛固酮(ALD)分别在第三天和第二天后升高。在血容量恢复(NSD)期间,第三天后ANF升高;相比之下,PRA和ALD下降得更早。对另外7名维持低盐饮食(50 mmol氯化钠/天)的受试者在输注ANF期间(2、4、8 ng/分钟/千克体重)进行了研究。ANF从10.3(标准误0.9)pg/ml(基础状态)升高至24.0(标准误1.9)pg/ml(输注研究)水平,在同一受试者摄入NSD后生理情况下也会出现这种升高,引起UNaV升高,这占平衡NSD所需UNaV升高的62%,而PRA或ALD没有变化。与PRA或ALD不同,血浆ANF与UNaV直接相关。
(a)在VLSD期间,ANF比PRA和血浆醛固酮变化更早;(b)在从低血容量恢复过程中,PRA和ALD比ANF反应更迅速;(c)在摄入低盐饮食期间,输注引起的血浆ANF变化占从低盐饮食转变为正常盐饮食后UNaV升高的一半以上,与PRA和ALD的变化无关。