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血浆肾素的慢性激活与饮食中的钠呈对数线性关系,并消除了因全身钠含量的脉冲式变化而引起的利钠作用。

Chronic activation of plasma renin is log-linearly related to dietary sodium and eliminates natriuresis in response to a pulse change in total body sodium.

作者信息

Kjolby Mads, Bie Peter

机构信息

Department of Physiology and Pharmacology, Institute of Medical Biology, University of Southern Denmark, Odense, Denmark.

出版信息

Am J Physiol Regul Integr Comp Physiol. 2008 Jan;294(1):R17-25. doi: 10.1152/ajpregu.00435.2007. Epub 2007 Nov 7.

Abstract

Responses to acute sodium loading depend on the load and on the level of chronic sodium intake. To test the hypothesis that an acute step increase in total body sodium (TBS) elicits a natriuretic response, which is dependent on the chronic level of TBS, we measured the effects of a bolus of NaCl during different low-sodium diets spanning a 25-fold change in sodium intake on elements of the renin-angiotensin-aldosterone system (RAAS) and on natriuresis. To custom-made, low-sodium chow (0.003%), NaCl was added to provide four levels of intake, 0.03-0.75 mmol.kg(-1).day(-1) for 7 days. Acute NaCl administration increased PV (+6.3-8.9%) and plasma sodium concentration (~2%) and decreased plasma protein concentration (-6.4-8.1%). Plasma ANG II and aldosterone concentrations decreased transiently. Potassium excretion increased substantially. Sodium excretion, arterial blood pressure, glomerular filtration rate, urine flow, plasma potassium, and plasma renin activity did not change. The results indicate that sodium excretion is controlled by neurohumoral mechanisms that are quite resistant to acute changes in plasma volume and colloid osmotic pressure and are not down-regulated within 2 h. With previous data, we demonstrate that RAAS variables are log-linearly related to sodium intake over a >250-fold range in sodium intake, defining dietary sodium function lines that are simple measures of the sodium sensitivity of the RAAS. The dietary function line for plasma ANG II concentration increases from theoretical zero at a daily sodium intake of 17 mmol Na/kg (intercept) with a slope of 16 pM increase per decade of decrease in dietary sodium intake.

摘要

对急性钠负荷的反应取决于负荷量以及慢性钠摄入量的水平。为了验证全身钠(TBS)急性阶梯式增加会引发利钠反应这一假设,该反应依赖于TBS的慢性水平,我们测量了在钠摄入量变化达25倍的不同低钠饮食期间,静脉推注氯化钠对肾素 - 血管紧张素 - 醛固酮系统(RAAS)各要素以及利钠作用的影响。对于定制的低钠食物(0.003%),添加氯化钠以提供四种摄入量水平,即0.03 - 0.75 mmol·kg⁻¹·d⁻¹,持续7天。急性给予氯化钠会使血浆容量增加(+6.3 - 8.9%)、血浆钠浓度升高(约2%),并使血浆蛋白浓度降低(-6.4 - 8.1%)。血浆血管紧张素II(ANG II)和醛固酮浓度短暂降低。钾排泄大幅增加。钠排泄、动脉血压、肾小球滤过率、尿流量、血浆钾和血浆肾素活性未发生变化。结果表明,钠排泄受神经体液机制控制,这些机制对血浆容量和胶体渗透压的急性变化具有很强的抵抗力,并且在2小时内不会下调。结合先前的数据,我们证明在钠摄入量超过250倍的范围内,RAAS变量与钠摄入量呈对数线性关系,定义了饮食钠功能线,这是RAAS钠敏感性的简单测量指标。血浆ANG II浓度的饮食功能线从每日钠摄入量为17 mmol Na/kg时的理论零值(截距)开始增加,斜率为每减少一个十年的饮食钠摄入量增加16 pM。

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