Blantz R C, Gabbai F B, Peterson O W, Thomson S C
Division of Nephrology-Hypertension, University of California, San Diego School of Medicine.
Kidney Int Suppl. 1991 Jun;32:S102-5.
Removal of one kidney results in prompt increases in urinary excretion of NaCl and water from the remaining kidney, followed rather soon thereafter by increases in glomerular filtration rate (GFR). At 12-15 h and 24 h after contralateral nephrectomy, the single nephron filtration rate (SNGFR) is increased, accompanied by parallel increases in absolute proximal tubular reabsorption, late proximal tubular and early distal tubular flow rates, suggesting that these events might be critical to the increased urinary excretion. However, micropuncture studies 2-4 h after contralateral nephrectomy demonstrate that increased SNGFR and even increased distal tubular flow rates are not requirements for augmented urinary excretion, suggesting that decreased tubular reabsorption in the most distal nephron segments causes the increase in urinary excretion. Analysis of TGF profiles by stop-flow pressure response at 2-4 h after contralateral nephrectomy have suggested suppression of TGF as assessed by a rightward shift in the turning point with increasing late proximal tubular perfusion. However, our studies have examined SNGFR responses and shown no suppression of TGF profiles but a downward shift in the operating point, suggesting activation of TGF and a modest reduction in SNGFR, determined from distal tubular collections. Although SNGFR was increased at all late proximal perfusion rates 12 h after nephrectomy, the turning point (V 1/2) was not altered. TGF profiles are not suppressed within 12 h after nephrectomy while SNGFR is increased. Suppression of TGF does not cause the increase in SNGFR after nephrectomy and TGF activity is maintained and adapts to increases in SNGFR caused by TGF-independent mechanisms.
切除一侧肾脏会导致剩余肾脏的氯化钠和水的尿排泄迅速增加,此后不久肾小球滤过率(GFR)也会增加。在对侧肾切除术后12 - 15小时和24小时,单个肾单位滤过率(SNGFR)增加,同时近端肾小管绝对重吸收、近端肾小管晚期和远端肾小管早期流速也平行增加,这表明这些事件可能对尿排泄增加至关重要。然而,对侧肾切除术后2 - 4小时的微穿刺研究表明,SNGFR增加甚至远端肾小管流速增加并非尿排泄增加的必要条件,这表明最远端肾单位段肾小管重吸收减少导致了尿排泄增加。通过对侧肾切除术后2 - 4小时的停流压力反应分析TGF曲线,结果表明随着近端肾小管晚期灌注增加,转折点右移,提示TGF受到抑制。然而,我们的研究检查了SNGFR反应,结果显示TGF曲线未受抑制,但工作点下移,提示TGF被激活,且根据远端肾小管收集情况确定SNGFR有适度降低。尽管肾切除术后12小时在所有近端肾小管晚期灌注率下SNGFR均增加,但转折点(V 1/2)未改变。肾切除术后12小时内TGF曲线未受抑制,而SNGFR增加。肾切除术后TGF的抑制不会导致SNGFR增加,且TGF活性得以维持并适应由TGF非依赖机制引起的SNGFR增加。