McClellan Jennifer M, Goldstein Richard E, Erb Hollis N, Dykes Ned L, Cowgill Larry D
Department of Clinical Sciences, New York State College of Veterinary Medicine, Cornell University, Ithaca, NY 14853, USA.
Am J Vet Res. 2006 Apr;67(4):715-22. doi: 10.2460/ajvr.67.4.715.
To determine effects of commonly used diuretic treatments on glomerular filtration rate (GFR), renal blood flow (RBF), and urine output (UO) and compare 2 methods of GFR measurement in healthy awake cats.
8 healthy cats.
In a randomized crossover design, cats were randomly allocated to 4 groups: control; IV administration of fluids; IV administration of fluids and mannitol; and IV administration of fluids, dopamine, and furosemide. Inulin and para-aminohippuric acid were used for determination of plasma clearance for GFR and RBF, respectively. Plasma clearance of technetium-Tc-99m-diethylenetriaminepentacetic acid (99mTc-DTPA) was also used for GFR determination.
Furosemide-dopamine induced the largest UO, compared with other groups. Both mannitol and fluid therapy increased RBF, compared with the control group. Mannitol, and not fluid therapy, increased RBF, compared with furosemide-dopamine. There were significant differences in GFR values calculated from 99mTc-DTPA and inulin clearances between the 2 groups. In all groups, use of 99mTc-DTPA caused underestimation of GFR, compared with use of inulin.
In healthy awake cats, administration of furosemide-dopamine did not increase GFR or RBF despite increased UO. Fluid therapy and fluid therapy plus mannitol improved RBF. Determination of GFR by use of 99mTc-DTPA cannot always be substituted for inulin clearance when accurate measurement is required.
确定常用利尿治疗对健康清醒猫肾小球滤过率(GFR)、肾血流量(RBF)和尿量(UO)的影响,并比较两种测量GFR的方法。
8只健康猫。
采用随机交叉设计,将猫随机分为4组:对照组;静脉输注液体;静脉输注液体和甘露醇;静脉输注液体、多巴胺和呋塞米。分别使用菊粉和对氨基马尿酸测定GFR和RBF的血浆清除率。锝-99m-二乙三胺五乙酸(99mTc-DTPA)的血浆清除率也用于测定GFR。
与其他组相比,呋塞米-多巴胺诱导的尿量最大。与对照组相比,甘露醇和液体疗法均增加了肾血流量。与呋塞米-多巴胺相比,甘露醇而非液体疗法增加了肾血流量。两组间根据99mTc-DTPA和菊粉清除率计算的GFR值存在显著差异。在所有组中,与使用菊粉相比,使用99mTc-DTPA导致GFR被低估。
在健康清醒猫中,尽管尿量增加,但给予呋塞米-多巴胺并未增加GFR或RBF。液体疗法以及液体疗法加甘露醇可改善肾血流量。当需要精确测量时,使用99mTc-DTPA测定GFR不能总是替代菊粉清除率。