Porush J G, Kaloyanides G J, Cacciaguida R J, Rosen S M
Department of Medicine, The Brookdale Hospital Center, Maimonides Hospital of Brooklyn, and State University of New York, Downstate Medical Center, Brooklyn, New York.
J Clin Invest. 1967 Dec;46(12):2109-22. doi: 10.1172/JCI105698.
The effects of intravenous administration of angiotensin II on renal water and electrolyte excretion were examined during hydropenia, water diuresis, and hypotonic saline diuresis in anesthetized normal dogs and dogs with thoracic inferior vena cava constriction and ascites (caval dogs). The effects of unilateral renal artery infusion of a subpressor dose were also examined.During hydropenia angiotensin produced a decrease in tubular sodium reabsorption, with a considerably greater natriuresis in caval dogs, and associated with a decrease in free water reabsorption (T(c) (H(2)O)). Water and hypotonic saline diuresis resulted in an augmented angiotensin natriuresis, with a greater effect still observed in caval dogs. In these experiments free water excretion (C(H(2)O)) was limited to 8-10% of the glomerular filtration rate (GFR), although distal sodium load increased in every instance. In the renal artery infusion experiments a significant ipsilateral decrease in tubular sodium reabsorption was induced, particularly in caval dogs.These findings indicate that angiotensin has a direct effect on renal sodium reabsorption unrelated to a systemic circulatory alteration. The attenuation or prevention of the falls in GFR and effective renal plasma flow (ERPF) usually induced by angiotensin may partially account for the greater natriuretic response in caval dogs and the augmentation during water or hypotonic saline diuresis. However, a correlation between renal hemodynamics and the degree of natriuresis induced was not always present and, furthermore, GFR and ERPF decreased significantly during the intrarenal artery infusion experiments. Therefore, the present experiments indicate that another mechanism is operative in the control of the angiotensin natriuresis and suggest that alterations in intrarenal hemodynamics may play a role.The decrease in T(c) (H(2)O) and the apparent limitation of C(H(2)O) associated with an increase in distal sodium load localize the site of action of angiotensin to the ascending limb of Henle's loop and the proximal tubule.
在麻醉的正常犬以及患有胸段下腔静脉缩窄和腹水的犬(腔静脉犬)中,分别在缺水、水利尿和低渗盐水利尿期间,研究了静脉注射血管紧张素II对肾脏水和电解质排泄的影响。还研究了单侧肾动脉输注低于升压剂量的血管紧张素II的影响。在缺水期间,血管紧张素使肾小管钠重吸收减少,腔静脉犬的排钠作用明显增强,同时自由水重吸收(T(c) (H(2)O))减少。水和低渗盐水利尿导致血管紧张素促钠排泄作用增强,腔静脉犬的这种作用更为明显。在这些实验中,尽管每种情况下远端钠负荷均增加,但自由水排泄(C(H(2)O))被限制在肾小球滤过率(GFR)的8 - 10%。在肾动脉输注实验中,诱导了同侧肾小管钠重吸收显著减少,腔静脉犬尤为明显。这些发现表明,血管紧张素对肾脏钠重吸收有直接作用,与全身循环改变无关。血管紧张素通常引起的GFR和有效肾血浆流量(ERPF)下降的减弱或预防,可能部分解释了腔静脉犬更大的利钠反应以及水或低渗盐水利尿期间的增强作用。然而,肾脏血流动力学与所诱导的利钠程度之间并不总是存在相关性,此外,在肾内动脉输注实验期间GFR和ERPF显著下降。因此,本实验表明,在血管紧张素利钠作用的控制中存在另一种机制,并提示肾内血流动力学改变可能起作用。T(c) (H(2)O)的减少以及与远端钠负荷增加相关的C(H(2)O)的明显限制,将血管紧张素的作用部位定位于亨氏袢升支和近端小管。