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腔静脉缩窄清醒犬对心房利钠因子的肾脏反应。

Renal response to atrial natriuretic factor in conscious dogs with caval constriction.

作者信息

Freeman R H, Davis J O, Vari R C

出版信息

Am J Physiol. 1985 Apr;248(4 Pt 2):R495-500. doi: 10.1152/ajpregu.1985.248.4.R495.

Abstract

Constriction of the thoracic inferior vena cava to decrease venous return and atrial filling markedly elevates plasma renin activity (PRA) and plasma aldosterone concentration (PAC) and produces chronic sodium retention and ascites in the dog. Infusion of a synthetic atrial natriuretic factor into conscious dogs with caval constriction and ascites at doses of 175 and 350 ng X kg-1 X min-1 for 30 min each produced striking increases (P less than 0.05) in creatinine clearance, diuresis, and kaliuresis but failed to increase urinary sodium excretion. Infusions of atrial natriuretic factor at these doses into conscious normal dogs, however, produced a striking increase in sodium excretion from 41 +/- 14 and 55 +/- 19 mu eq/min to 150 +/- 58 and 181 +/- 49 mu eq/min (P less than 0.05 for both values). Creatinine clearance and urine flow also increased in these normal dogs, but potassium excretion remained unchanged during the infusion periods. Atrial natriuretic factor produced parallel suppression (P less than 0.05) of the elevated levels of PRA and PAC in the caval dogs but failed to significantly decrease either PRA or PAC in the normal animals. Arterial pressure, heart rate, and PAH clearance were unchanged in both groups of dogs during infusion of atrial natriuretic factor. These results suggest that the pattern of renal electrolyte excretion elicited in response to the acute infusion of atrial natriuretic factor is dependent, at least partially, on the preexisting status of the renal tubules to facilitate sodium reabsorption and potassium excretion. The results also are consistent with the concept that atrial natriuretic factor might function to tonically inhibit the renin-angiotensin-aldosterone system.

摘要

缩窄胸段下腔静脉以减少静脉回流和心房充盈,可显著提高犬的血浆肾素活性(PRA)和血浆醛固酮浓度(PAC),并导致慢性钠潴留和腹水。给有意识的患有腔静脉缩窄和腹水的犬以175和350 ng·kg⁻¹·min⁻¹的剂量分别输注合成心房利钠因子30分钟,肌酐清除率、利尿和尿钾排泄均显著增加(P<0.05),但尿钠排泄未增加。然而,以这些剂量给有意识的正常犬输注心房利钠因子,钠排泄量从41±14和55±19 μeq/min显著增加至150±58和181±49 μeq/min(两者P值均<0.05)。这些正常犬的肌酐清除率和尿流量也增加,但输注期间钾排泄量保持不变。心房利钠因子使腔静脉缩窄犬升高的PRA和PAC水平受到平行抑制(P<0.05),但未使正常动物的PRA或PAC显著降低。在输注心房利钠因子期间,两组犬的动脉压、心率和对氨基马尿酸清除率均未改变。这些结果表明,急性输注心房利钠因子引起的肾电解质排泄模式至少部分取决于肾小管促进钠重吸收和钾排泄的预先存在状态。这些结果也与心房利钠因子可能发挥作用以持续抑制肾素-血管紧张素-醛固酮系统的概念一致。

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