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一种通过肾小管-肾小球反馈和肌源性反应实现肾血流自身调节的多肾单位模型。

A multinephron model of renal blood flow autoregulation by tubuloglomerular feedback and myogenic response.

作者信息

Oien A H, Aukland K

机构信息

Department of Mathematics, University of Bergen, Norway.

出版信息

Acta Physiol Scand. 1991 Sep;143(1):71-92. doi: 10.1111/j.1748-1716.1991.tb09203.x.

Abstract

Tubuloglomerular feedback implies that a primary increase in arterial pressure, renal blood flow, glomerular filtration and increased flow rate in the distal tubule increase preglomerular resistance and thereby counteract the primary rise in glomerular filtration rate and renal blood flow. Tubuloglomerular feedback has therefore been assumed to play a role in renal autoregulation, i.e., the constancy of renal blood flow and glomerular filtration at varying arterial pressure. In evaluating this hypothesis, the numerous tubular and vascular mechanisms involved have called for mathematical models. Based on a single nephron model we have previously concluded that tubuloglomerular feedback can account for only a small part of blood flow autoregulation. We now present a more realistic multinephron model, consisting of one interlobular artery with an arbitrary number of evenly spaced afferent arterioles. Feedback from the distal tubule was simulated by letting glomerular blood flow exert a positive feedback on preglomerular resistance, in each case requiring compatibility with experimental open-loop responses in the most superficial nephron. The coupling together of 10 nephrons per se impairs autoregulation of renal blood flow compared to that of a single nephron model, but this effect is more than outweighed by greater control resistance in deep arterioles. Some further improvement was obtained by letting the contractile response spread from each afferent arteriole to the nearest interlobular artery segment. Even better autoregulation was provided by spreading of full strength contraction also to the nearest upstream or downstream afferent arteriole, and spread to both caused a renal blood flow autoregulation approaching experimental observations. However, when the spread effect was reduced to 25% of that in each stimulated afferent arteriole, more compatible with recent experimental observations, the autoregulation was greatly impaired. Some additional mechanism seems necessary, and we found that combined myogenic response in interlobular artery and tubuloglomerular feedback regulation of afferent arterioles can mimic experimental pressure-flow curves.

摘要

管球反馈意味着动脉压、肾血流量、肾小球滤过率的原发性增加以及远曲小管流速的增加会增加球前阻力,从而抵消肾小球滤过率和肾血流量的原发性升高。因此,管球反馈被认为在肾自身调节中起作用,即在不同动脉压下肾血流量和肾小球滤过率的恒定。在评估这一假设时,所涉及的众多肾小管和血管机制需要数学模型。基于单个肾单位模型,我们先前得出结论,管球反馈仅能解释血流量自身调节的一小部分。我们现在提出一个更现实的多肾单位模型,该模型由一条叶间动脉和任意数量均匀分布的入球小动脉组成。通过让肾小球血流量对球前阻力施加正反馈来模拟远曲小管的反馈,在每种情况下都需要与最表层肾单位的实验开环反应相匹配。与单个肾单位模型相比,10个肾单位耦合在一起本身就会损害肾血流量的自身调节,但这种影响被深部小动脉中更大的控制阻力所抵消。通过让收缩反应从每个入球小动脉扩散到最近的叶间动脉段,可获得进一步的改善。通过将完全强度的收缩也扩散到最近的上游或下游入球小动脉,能提供更好的自身调节,而同时扩散到两者会使肾血流量自身调节接近实验观察结果。然而,当扩散效应降低到每个受刺激入球小动脉的25%时,这与最近的实验观察结果更相符,但自身调节会受到极大损害。似乎需要一些额外的机制,并且我们发现叶间动脉中的联合肌源性反应和入球小动脉的管球反馈调节可以模拟实验压力 - 流量曲线。

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