Holechek Mary Jo
Johns Hopkins Hospital, Transplant Surgery Service, Baltimore, MD, USA.
Nephrol Nurs J. 2003 Aug;30(4):441-6; quiz 447-8.
The formation of urine is a process that begins with glomerular filtration and is greatly influenced by changes in renal hemodynamics. Selective filtration of the blood is possible because of the unique characteristics of the glomerulus and renal circulation. Many factors interact to maintain a consistent blood flow allowing filtration and urine formation to continue despite systemic changes in blood pressure. Factors that impact on renal hemodynamics include the autoregulatory mechanism, the renin-angiotensin mechanism, eicosanoids, kinins, the sympathetic nervous system (SNS), catecholamines, antidiuretic hormone, endothelin, nitric oxide, atrial natriuretic peptide, and dopamine. Knowledge of the effects of these factors will allow the nephrology nurse to predict, identify, and assist in the treatment of clinical conditions that can alter renal hemodynamics and glomerular filtration.
尿液的形成始于肾小球滤过，这一过程受肾血流动力学变化的显著影响。由于肾小球和肾循环的独特特性，血液得以进行选择性滤过。尽管血压会发生全身性变化，但许多因素相互作用以维持恒定的血流，从而使滤过和尿液形成得以持续。影响肾血流动力学的因素包括自身调节机制、肾素 - 血管紧张素机制、类花生酸、激肽、交感神经系统（SNS）、儿茶酚胺、抗利尿激素、内皮素、一氧化氮、心钠素和多巴胺。了解这些因素的作用将有助于肾病科护士预测、识别并协助治疗可能改变肾血流动力学和肾小球滤过的临床病症。
