In order to examine the handling of sodium by the nephrotic kidney when separated from the immediate influences of renal nerves and humoral factors, kidneys were taken from nephrotic rats (puromycin aminonucleoside) and studied over a range of perfusion pressures using the isolated perfused kidney technique. 2. When perfused with medium containing 6.7 g/dl albumin, the nephrotic kidneys performed differently from controls with a reduction in sodium excretion at all pressures [(mean +/- SEM) 1.14 +/- 0.43 vs 4.20 +/- 0.69 mumol/min at 105 mmHg (14 kPa); 6.32 +/- 1.56 vs 44.60 +/- 5.30 mumol/min at 150 mmHg (20 kPa)]. Renal vascular resistance, inulin clearance, fractional sodium excretion and fractional lithium excretion were also reduced. 3. When kidneys were perfused without oncotic agent these differences between nephrotic and control kidneys remained. Perfusion with medium containing 10 g/dl albumin, designed to prevent glomerular filtration, abolished the difference in vascular resistance between the two groups. Captopril had no effect on the sodium retention or vascular resistance of nephrotic kidneys. 4. It was concluded that (a) the isolated nephrotic kidney demonstrates increased avidity for sodium, (b) the abnormality of sodium handling is not dependent on the presence of altered oncotic forces, and (c) the alteration in vascular resistance is conditional upon glomerular filtration.
摘要
为了研究肾病肾脏在脱离肾神经和体液因素的直接影响时对钠的处理情况,从肾病大鼠(嘌呤霉素氨基核苷)获取肾脏,并使用离体灌注肾脏技术在一系列灌注压力下进行研究。2. 当用含6.7 g/dl白蛋白的培养基灌注时,肾病肾脏的表现与对照不同,在所有压力下钠排泄均减少[(均值±标准误)在105 mmHg(14 kPa)时为1.14±0.43 vs 4.20±0.69 μmol/min;在150 mmHg(20 kPa)时为6.32±1.56 vs 44.60±5.30 μmol/min]。肾血管阻力、菊粉清除率、钠排泄分数和锂排泄分数也降低。3. 当肾脏在没有胶体渗透压剂的情况下灌注时,肾病肾脏与对照肾脏之间的这些差异仍然存在。用含10 g/dl白蛋白的培养基灌注以防止肾小球滤过,消除了两组之间血管阻力的差异。卡托普利对肾病肾脏的钠潴留或血管阻力没有影响。4. 得出的结论是:(a)离体肾病肾脏对钠的亲和力增加;(b)钠处理异常不依赖于胶体渗透压改变的存在;(c)血管阻力的改变取决于肾小球滤过。