Kornerup H J
Scand J Clin Lab Invest. 1978 Apr;38(2):147-53. doi: 10.1080/00365517809156083.
The purpose of the present study was to examine the influence of different sodium loads on renin release in the hypertensive and normotensive state of chronic renal failure. Blood pressure (BP), plasma renin concentration (PRC) and exchangeable sodium (NaE) were measured in eighteen patients with advanced chronic renal failure, nine hypertensives and nine normotensives, and in seven normal subjects (a) 6 days after a fixed sodium intake of 10 mmol/day, and (b) 6 days after a fixed sodium intake of 150 mmol/day. Mean NaE was 14-19% higher in the hypertensives compared with the normotensives and values of NaE correlated significantly to values of mean BP. No significant differences were present in PRC between the groups of patients and controls on either of the sodium regimens and no correlation was found between BP and PRC. However, average decreases of PRC in the hypertensives on high sodium intake, 33-34%, were significantly lower than the corresponding values of 69-71% in the normotensive patients and controls, respectively. Furthermore, the percentage changes of PRC on high sodium intake correlated significantly to mean BP as well as to NaE. These results suggest that renin release is relatively unresponsive to different sodium intakes in hypertension following chronic renal failure. This alteration in renin release may contribute to the maintenance of hypertension in chronic renal failure, PRC being "inappropriately' increased in relationship to the sodium excess.
本研究的目的是探讨不同钠负荷对慢性肾衰竭高血压和血压正常状态下肾素释放的影响。对18例晚期慢性肾衰竭患者（其中9例高血压患者和9例血压正常患者）以及7名正常受试者测量血压（BP）、血浆肾素浓度（PRC）和可交换钠（NaE）：(a)在固定钠摄入量为10 mmol/天6天后；(b)在固定钠摄入量为150 mmol/天6天后。与血压正常者相比，高血压患者的平均NaE高14 - 19%，且NaE值与平均血压值显著相关。在两种钠摄入方案下，患者组和对照组之间的PRC均无显著差异，且未发现血压与PRC之间存在相关性。然而，高钠摄入时高血压患者的PRC平均下降幅度为33 - 34%，显著低于血压正常患者和对照组相应的69 - 71%。此外，高钠摄入时PRC的百分比变化与平均血压以及NaE均显著相关。这些结果表明，慢性肾衰竭高血压患者的肾素释放对不同钠摄入量相对无反应。肾素释放的这种改变可能有助于维持慢性肾衰竭患者的高血压状态，相对于钠过量，PRC“不适当”升高。
