Seeliger Erdmann, Andersen Jens Lundbaek, Bie Peter, Reinhardt H Wolfgang
Institute of Physiology, University Clinics Charité, Berlin, Germany.
J Physiol. 2004 Sep 15;559(Pt 3):939-51. doi: 10.1113/jphysiol.2004.066670. Epub 2004 Jul 14.
The study was designed to determine to what extent moderate elevation of renal perfusion pressure (RPP) via the mechanism of 'pressure natriuresis' contributes to the natriuresis induced by acute i.v. saline loading. Nine Beagle dogs maintained on ample sodium intake (5.5 mmol (kg body mass)(-1) day(-1)) were chronically equipped with an aortic occluder to servocontrol RPP, a bladder catheter to measure renal function, and catheters for measurement of RPP and mean arterial blood pressure (MABP). A swivel system allowed free movement in the kennel during experiments. Isotonic saline loading (500 ml in 100 min) was studied as follows: with and without servocontrol of RPP, and these two protocols repeated in the presence of angiotensin-converting enzyme inhibition (ACEI, Enalapril, 2 mg (kg body mass)(-1)). Saline loading increased MABP by about 12 mmHg and sodium excretion from about 28 micromol min(-1) up to about 350 micromol min(-1). Without ACEI, servocontrol of RPP at 10% below control 24 h MABP slightly delayed the onset of the saline-induced natriuresis, but did not reduce peak sodium excretion or cumulative sodium excretion. The slight delay most probably resulted from pressure-controlled renin release because, with ACEI, servocontrol of RPP did not delay or reduce the saline-induced natriuresis. In conclusion, pressure natriuresis does not contribute to the natriuresis following acute saline loading.
本研究旨在确定通过“压力性利钠”机制使肾灌注压(RPP)适度升高在多大程度上有助于急性静脉输注生理盐水负荷诱导的利钠作用。九只维持充足钠摄入(5.5 mmol·(kg体重)(-1)·天(-1))的比格犬长期配备主动脉阻断器以伺服控制RPP、膀胱导管以测量肾功能,以及用于测量RPP和平均动脉血压(MABP)的导管。一个旋转系统使犬在实验期间能在犬舍内自由活动。如下研究等渗盐水负荷(100分钟内输注500 ml):有和没有RPP的伺服控制,并且这两种方案在存在血管紧张素转换酶抑制(ACEI,依那普利,2 mg·(kg体重)(-1))的情况下重复进行。盐水负荷使MABP升高约12 mmHg,钠排泄从约28 μmol·分钟(-1)增加至约350 μmol·分钟(-1)。在没有ACEI的情况下,将RPP伺服控制在比对照24小时MABP低10%时,盐水诱导的利钠作用的起始稍有延迟,但并未降低钠排泄峰值或累积钠排泄量。这种轻微延迟很可能是由压力控制的肾素释放导致的,因为在使用ACEI时,RPP的伺服控制并未延迟或降低盐水诱导的利钠作用。总之,压力性利钠并不促成急性盐水负荷后的利钠作用。