Hughes J M, Beck T R, Rose C E, Carey R M
Department of Internal Medicine, University of Virginia Medical Center, Charlottesville 22908.
J Clin Endocrinol Metab. 1988 Mar;66(3):518-25. doi: 10.1210/jcem-66-3-518.
We studied the actions of iv fenoldopam, a selective dopamine-1 (DA-1) receptor agonist, in 10 normal men eating a diet containing 150 meq sodium and 60 meq potassium per day. During DA-1 receptor stimulation systemic hemodynamic function did not change. Fenoldopam resulted in an increase in urine flow rate from 13 +/- 1 (+/- SE) to a peak of 17 +/- 2 mL/min (P less than 0.05) and an increase in renal plasma flow from 344 +/- 39 to 481 +/- 44 mL/min (P less than 0.05). Urinary sodium excretion and fractional excretion of sodium both increased. Urinary sodium excretion rose to a maximum of 0.32 +/- 0.05 compared with a control value of 0.21 +/- 0.03 meq/min (P less than 0.01), while fractional excretion of sodium rose to 2.7 +/- 0.6 compared with a control value of 1.6 +/- 0.1% (P less than 0.05). The glomerular filtration rate did not change. Administration of a predominantly DA-2 antagonist during continuous DA-1 receptor stimulation did not block the fenoldopam-induced natriuresis. The rise in plasma aldosterone concentration after metoclopramide administration was blunted by DA-1 receptor activation [19.2 +/- 2.9 during control compared with 12.7 +/- 1.3 ng/dL (P less than 0.01) during fenoldopam]. No change occurred in serum potassium, plasma cortisol, or PRA. We conclude that selective DA-1 receptor stimulation in man produces sustained natriuresis and inhibition of aldosterone release by direct renal and adrenal effects.
我们研究了静脉注射非诺多泮（一种选择性多巴胺 -1（DA-1）受体激动剂）对10名正常男性的作用，这些男性每天摄入含150毫当量钠和60毫当量钾的饮食。在DA-1受体刺激期间，全身血流动力学功能未发生变化。非诺多泮使尿流率从13±1（±标准误）增加到峰值17±2毫升/分钟（P<0.05），肾血浆流量从344±39增加到481±44毫升/分钟（P<0.05）。尿钠排泄和钠分数排泄均增加。尿钠排泄最高升至0.32±0.05，而对照值为0.21±0.03毫当量/分钟（P<0.01），钠分数排泄升至2.7±0.6，对照值为1.6±0.1%（P<0.05）。肾小球滤过率未改变。在持续DA-1受体刺激期间给予主要的DA-2拮抗剂并不能阻断非诺多泮诱导的利钠作用。甲氧氯普胺给药后血浆醛固酮浓度的升高被DA-1受体激活所减弱[对照期间为19.2±2.9，而非诺多泮期间为12.7±1.3纳克/分升（P<0.01）]。血清钾、血浆皮质醇或肾素活性未发生变化。我们得出结论，在人体中选择性刺激DA-1受体可通过直接的肾脏和肾上腺作用产生持续的利钠作用并抑制醛固酮释放。
