Levy M, Cernacek P
Department of Physiology, McGill University, Montreal, Quebec, Canada.
Am J Physiol. 1989 Feb;256(2 Pt 2):F211-7. doi: 10.1152/ajprenal.1989.256.2.F211.
The ability of atrial natriuretic peptide (ANP) to preserve renal function in dogs with hypovolemic acute renal insufficiency was tested in anesthetized dogs 4 h after the induction of acute pancreatitis. Plasma volume had decreased by 21.5% and glomerular filtration rate (GFR) by 43.2%. Blood pressure had declined by 30 mmHg. ANP was given intravenously at 50 and 150 ng.kg-1.min-1. With the lower dose, blood pressure (BP), GFR, and clearance of p-aminohippuric acid (CPAH) did not change but urine flow (V) and sodium excretion (UNaV) increased. With the higher dose, BP declined by 25 mmHg, GFR declined, but V and UNaV still increased. When plasma volume was maintained with 4% colloid during the progression of pancreatitis and ANP 50 ng.kg-1.min-1 given, BP declined, GFR did not change, and there was a magnified increment in V and UNaV. The administration of glucagon (5 micrograms/min iv) to dogs with hypovolemic pancreatitis caused BP to decline by 17 mmHg. Despite a major increment in GFR, fractional excretion of sodium increased only slightly, compared with that obtained with ANP. We conclude that glucagon preserves GFR more effectively than ANP in hypovolemia, but ANP is more effective in protecting urinary water and sodium excretion.
在急性胰腺炎诱导4小时后的麻醉犬中,测试了心房利钠肽(ANP)对低血容量性急性肾功能不全犬肾功能的保护能力。血浆量减少了21.5%,肾小球滤过率(GFR)减少了43.2%。血压下降了30 mmHg。以50和150 ng·kg-1·min-1的剂量静脉注射ANP。较低剂量时,血压(BP)、GFR和对氨基马尿酸清除率(CPAH)未改变,但尿流量(V)和钠排泄量(UNaV)增加。较高剂量时,BP下降25 mmHg,GFR下降,但V和UNaV仍增加。在胰腺炎进展过程中用4%胶体维持血浆量并给予50 ng·kg-1·min-1的ANP时,BP下降,GFR未改变,V和UNaV有更大幅度的增加。给低血容量性胰腺炎犬静脉注射胰高血糖素(5微克/分钟)导致BP下降17 mmHg。尽管GFR大幅增加,但与ANP相比,钠分数排泄仅略有增加。我们得出结论,在低血容量时,胰高血糖素比ANP更有效地维持GFR,但ANP在保护尿水和钠排泄方面更有效。