Conger J D, Falk S A, Yuan B H, Schrier R W
University of Colorado Health Sciences Center, Denver.
Kidney Int. 1989 May;35(5):1126-32. doi: 10.1038/ki.1989.100.
Atrial natriuretic peptide (ANP) has been shown to reverse experimental models of ischemic acute renal failure (ARF). However, infusion of ANP has been associated with systemic hypotension making its use in clinical ARF impractical. Therefore, in this investigation, dopamine (D) was combined with intravenous (i.v.) atriopeptin III (AP III) to determine if this regimen was effective in reversing ARF while preventing systemic hypotension and maintaining renal blood flow (RBF). Four groups of Munich-Wistar rats were studied. Group 1, sham-ARF; Group 2, renal artery (RA) clamp (55 min) followed by i.v. saline; Group 3, RA clamp followed by i.v. AP III-D; and Group 4, RA clamp followed by i.v. D only. All infusions were begun after RA clamp release and continued for four hour. Mean arterial pressure in Group 3 rats given AP III-D were similar to that in Group 2, slightly less than that in Groups 1 and 4 (P less than 0.05), but consistently greater than 100 mm Hg during the four hour infusion. RBF in Group 3 was elevated above the level in Group 1 at P less than 0.05. Glomerular filtration rate (GFR), depressed by 52% in Group 2, was corrected to control (sham-ARF) levels in Group 3. In Group 4 there was a small but significant increase in GFR compared to Group 2 (P less than 0.05), but it remained less than that in sham-ARF or AP III-D treated ARF rats (P less than 0.01). Urine flow rate and urine sodium excretion rate were more than sixfold higher in Group 3 than any other group.(ABSTRACT TRUNCATED AT 250 WORDS)
心房利钠肽(ANP)已被证明可逆转缺血性急性肾衰竭(ARF)的实验模型。然而,输注ANP与系统性低血压有关,这使得其在临床ARF中的应用不切实际。因此,在本研究中,将多巴胺(D)与静脉注射心房肽III(AP III)联合使用,以确定该方案在逆转ARF的同时预防系统性低血压并维持肾血流量(RBF)是否有效。对四组慕尼黑-威斯塔大鼠进行了研究。第1组,假手术-ARF;第2组,肾动脉(RA)夹闭(55分钟),随后静脉注射生理盐水;第3组,RA夹闭,随后静脉注射AP III-D;第4组,RA夹闭,随后仅静脉注射D。所有输注均在RA夹闭松开后开始,并持续4小时。给予AP III-D的第3组大鼠的平均动脉压与第2组相似,略低于第1组和第4组(P<0.05),但在4小时输注期间始终大于100 mmHg。第3组的RBF在P<0.05时高于第1组。第2组肾小球滤过率(GFR)降低了52%,第3组则恢复到对照(假手术-ARF)水平。与第2组相比,第4组的GFR有小幅但显著的增加(P<0.05),但仍低于假手术-ARF或接受AP III-D治疗的ARF大鼠(P<0.01)。第3组的尿流率和尿钠排泄率比其他任何组高六倍以上。(摘要截选至250字)