Department of Pathology, Stanford University School of Medicine, San Francisco.
J Exp Med. 1941 Aug 31;74(3):167-75. doi: 10.1084/jem.74.3.167.
By using kerosene and avoiding postmortem rigor one can obtain perfusion rates in kidneys nearly five times faster than those reported by observers who perfused kidneys immediately post mortem with saline solution, only half as viscous as kerosene. The results obtained by kerosene perfusion indicate possible renal blood flow 50 to 100 per cent greater than that measured by Smith and his coworkers (7) in living men by diodrast clearance under normal conditions, and about as high as those observed in febrile subjects. Like the diodrast method, kerosene perfusion shows a striking decrease in renal vascular bed between early matuity (age 18 to 35) and senescence (45 to 60). This decrease is about 25 per cent. Most kidneys from patients with hypertension without uremia have vascular beds in the normal range, but a few show great decreases in capacity for blood flow. This evidence is interpreted as another indication that renal arteriosclerosis is often a result, rarely a cause of hypertension. Significant occlusion of large renal arteries is rare. Uremia due to amyloid may occur with no significant decrease in renal vascular bed, but the uremia of renal sclerosis, glomerulo- or pyelonephritis is associated with reduction of vascular bed to very low levels.
通过使用煤油并避免死后僵直，可以使肾脏的灌注率比那些仅用盐水立即进行死后灌注的观察者报告的灌注率快近五倍，而煤油的粘性仅为盐水的一半。煤油灌注得到的结果表明，可能的肾血流量比史密斯及其同事（7）在正常情况下通过二碘酞清除测量的活人中的肾血流量高 50%至 100%，与发热患者观察到的血流量相当。与二碘酞方法一样，煤油灌注显示在早期成熟（18 至 35 岁）和衰老（45 至 60 岁）之间肾脏血管床明显减少。这种减少约为 25%。大多数来自无尿毒症的高血压患者的肾脏血管床处于正常范围，但少数显示出血流量能力的大幅下降。这一证据被解释为另一个表明肾动脉硬化通常是高血压的结果，而不是原因的迹象。大肾动脉的显著闭塞很少见。淀粉样变性引起的尿毒症可能没有明显的血管床减少，但肾硬化、肾小球肾炎或肾盂肾炎引起的尿毒症与血管床减少到非常低的水平有关。
