Aliaga L, Zozaya J M, Quiroga J, Richter J A, Prieto J
Departamento de Medicina Interna, Clínica Universitaria de Navarra, Pamplona, Spain.
Rev Esp Fisiol. 1989;45 Suppl:371-5.
The interrelationship between renal hemodynamics and the renin-angiotensin-aldosterone system in 28 nonazotemic cirrhotic patients has been studied. Patients were divided into three groups: A) Patients without ascites nor edema; B) Patients with ascites and a relatively high sodium excretion (41.9 +/- 12.9 mmol/day); and C) Patients with ascites and very low sodium excretion (4.8 +/- 0.6 mmol/day). Renin and aldosterone levels significantly increased in group C. A significant correlation was observed between plasma aldosterone concentration and urinary sodium excretion, and between plasma renin activity and aldosterone levels. There were no significant differences in urine flow, glomerular filtration rate, effective renal plasma flow, or renal blood flow between the three groups of patients, in spite of marked differences in renin and aldosterone levels. Renal perfusion was not related to plasma renin activity either in the overall sample of patients or in the individual groups. These results show that factors other than total renal perfusion are involved in renin secretion in cirrhosis.
对28例非氮质血症肝硬化患者的肾血流动力学与肾素-血管紧张素-醛固酮系统之间的相互关系进行了研究。患者被分为三组：A）无腹水和水肿的患者；B）有腹水且钠排泄相对较高（41.9±12.9 mmol/天）的患者；C）有腹水且钠排泄极低（4.8±0.6 mmol/天）的患者。C组肾素和醛固酮水平显著升高。观察到血浆醛固酮浓度与尿钠排泄之间、血浆肾素活性与醛固酮水平之间存在显著相关性。尽管三组患者的肾素和醛固酮水平存在明显差异，但三组患者的尿流量、肾小球滤过率、有效肾血浆流量或肾血流量均无显著差异。无论是在患者的总体样本中还是在各个组中，肾灌注均与血浆肾素活性无关。这些结果表明，除了总肾灌注外，其他因素也参与了肝硬化患者肾素的分泌。
