Bidani A K, Mitchell K D, Schwartz M M, Navar L G, Lewis E J
Rush-Presbyterian-St. Luke's Medical Center, Chicago, Illinois.
Kidney Int. 1990 Jul;38(1):28-38. doi: 10.1038/ki.1990.163.
Severe reduction in renal mass (greater than 50%) in the rat uniformly results in progressive glomerular injury and loss of remnant nephrons postulated to be due to increases in glomerular function (hyperfiltration) and/or size (hypertrophy). Reduction in renal mass in the rat also leads to the development of systemic and/or glomerular hypertension. To examine the independent contributions of systemic hypertension and glomerular hyperfiltration and/or hypertrophy to progressive glomerular injury, a normotensive rat remnant kidney model was developed in the Wistar-Kyoto (WKY) strain. Of the 34 WKY rats that underwent 5/6 nephrectomy, 25 remained normotensive and without evidence of morphologic glomerular injury and/or nephron loss for up to 14 to 16 weeks, despite glomerular hyperfiltration and hypertrophy comparable to that previously observed in other rat strains. Micropuncture studies at approximately six weeks after reduction in renal mass demonstrated markedly increased SNGFR in remnant nephrons of normotensive rats as compared to controls (66 +/- 7 vs. 25 +/- 4 nl/min, P less than 0.01), but glomerular capillary pressures (PGC) estimated from stop flow pressures were only slightly increased (52.7 +/- 1 vs. 47.3 +/- 1 mm Hg, P less than 0.01). These data indicate that compensatory glomerular hyperfiltration and hypertrophy after 5/6 nephrectomy may not lead to progressive glomerular injury provided hypertension does not develop. These data further suggest that in the absence of systemic hypertension, increases in PGC required for adaptive hyperfiltration, may not be sufficient to initiate progressive glomerular injury and nephron loss.
大鼠肾质量严重减少(超过50%)通常会导致渐进性肾小球损伤和残余肾单位丧失,据推测这是由于肾小球功能增加(超滤过)和/或大小增加(肥大)所致。大鼠肾质量减少还会导致全身性和/或肾小球性高血压的发展。为了研究全身性高血压以及肾小球超滤过和/或肥大对渐进性肾小球损伤的独立作用,在Wistar-Kyoto(WKY)品系中建立了一种血压正常的大鼠残余肾模型。在接受5/6肾切除术的34只WKY大鼠中,25只在长达14至16周的时间内血压正常,且没有形态学上的肾小球损伤和/或肾单位丧失的证据,尽管其肾小球超滤过和肥大程度与先前在其他大鼠品系中观察到的相当。肾质量减少后约六周进行的微穿刺研究表明,与对照组相比,血压正常大鼠残余肾单位的单个肾单位肾小球滤过率(SNGFR)显著增加(66±7对25±4 nl/min,P<0.01),但根据停流压力估算的肾小球毛细血管压力(PGC)仅略有增加(52.7±1对47.3±1 mmHg,P<0.01)。这些数据表明,如果不发生高血压,5/6肾切除术后代偿性肾小球超滤过和肥大可能不会导致渐进性肾小球损伤。这些数据进一步表明,在没有全身性高血压的情况下,适应性超滤过所需的PGC增加可能不足以引发渐进性肾小球损伤和肾单位丧失。