Hughes J M, Ragsdale N V, Felder R A, Chevalier R L, King B, Carey R M
Department of Internal Medicine, University of Virginia School of Medicine, Charlottesville 22908.
Hypertension. 1988 Feb;11(2 Pt 2):I69-74. doi: 10.1161/01.hyp.11.2_pt_2.i69.
Stimulation of renal dopamine-1 (DA1) receptors for 3 hours produces an increase in renal plasma flow and sustained natriuresis. The present study was designed to assess the response of renal hemodynamic and tubular function to long-term DA1 receptor stimulation. Fenoldopam, a selective DA1 receptor agonist, was infused intravenously for 24 hours in 10 normal male subjects in metabolic balance at 150 mEq sodium and 60 mEq potassium intake in a single-blind, vehicle-controlled protocol. During DA1 receptor activation, urine flow rate and fractional excretion of sodium increased for the first 5 hours, 16.9 +/- 0.9 ml/min compared with a vehicle control value of 12.4 +/- 0.5 ml/min (p less than 0.001) and 2.0 +/- 0.1% compared with a vehicle control value of 1.1 +/- 0.1% (p less than 0.005), respectively. Urinary sodium excretion rose at 5 hours, 0.27 +/- 0.02 mEq/min compared with a vehicle control value of 0.14 +/- 0.01 mEq/min (p less than 0.01). Renal plasma flow increased during fenoldopam at 5 hours, 505 +/- 47 ml/min compared with a vehicle control value of 397 +/- 25 ml/min (p less than 0.01), and was sustained for 24 hours, 523 +/- 40 ml/min compared with 432 +/- 31 ml/min (p less than 0.05). The distal sodium load increased and the percentage of distal sodium reabsorption decreased during fenoldopam. Glomerular filtration rate, blood pressure, heart rate, plasma aldosterone concentration, plasma renin activity, and fractional excretion of potassium were unchanged. Selective DA1 receptor activation produced sustained 5-hour diuresis and 11-hour natriuresis without kaliuresis or a systemic hemodynamic effect.(ABSTRACT TRUNCATED AT 250 WORDS)
刺激肾多巴胺 -1（DA1）受体3小时可使肾血浆流量增加并产生持续性利钠作用。本研究旨在评估长期刺激DA1受体时肾血流动力学和肾小管功能的反应。在一项单盲、以溶媒为对照的实验方案中，对10名处于代谢平衡状态、钠摄入量为150 mEq、钾摄入量为60 mEq的正常男性受试者静脉输注选择性DA1受体激动剂非诺多泮24小时。在DA1受体激活期间，最初5小时尿流率和钠分数排泄增加，尿流率为16.9±0.9 ml/min，而溶媒对照值为12.4±0.5 ml/min（p＜0.001）；钠分数排泄为2.0±0.1%，而溶媒对照值为1.1±0.1%（p＜0.005）。5小时时尿钠排泄增加，为0.27±0.02 mEq/min，而溶媒对照值为0.14±0.01 mEq/min（p＜0.01）。非诺多泮输注5小时时肾血浆流量增加，为505±47 ml/min，而溶媒对照值为397±25 ml/min（p＜0.01），并持续24小时，为523±40 ml/min，而对照值为432±31 ml/min（p＜0.05）。非诺多泮输注期间远端钠负荷增加，远端钠重吸收百分比降低。肾小球滤过率、血压、心率、血浆醛固酮浓度、血浆肾素活性和钾分数排泄均未改变。选择性DA1受体激活产生持续5小时的利尿作用和11小时的利钠作用，而无尿钾增多或全身血流动力学效应。（摘要截短于250字）
