Meyer T W, Rennke H G
Department of Medicine, Stanford University, Palo Alto, California.
Am J Physiol. 1988 Jun;254(6 Pt 2):F856-62. doi: 10.1152/ajprenal.1988.254.6.F856.
Wistar Munich rats subjected to partial renal ablation were compared with intact rats. Group 1 rats were subjected to bilateral segmental infarction of 40% of their total renal mass. Group 2 rats underwent uninephrectomy. Group 3 rats underwent sham operation. Micropuncture and morphological studies were performed in each group at 28 wk after operation. In group 1, glomerular capillary pressure was elevated by 7 mmHg and systemic blood pressure was elevated by 31 mmHg despite reduction of nephron number by only 40% and reduction of glomerular filtration rate (GFR) by only 10%. Progressive albuminuria and segmental glomerular sclerosis were associated with elevation of glomerular capillary pressure in this group. In group 2, single-nephron glomerular filtration rate (SNGFR) was higher than in group 1, but systemic and glomerular capillary pressure remained normal. Group 2 rats developed markedly less albuminuria and glomerular sclerosis than group 1 rats despite more pronounced remnant nephron hyperfiltration. These studies support the view that glomerular hypertension is the major hemodynamic derangement contributing to remnant glomerular injury and show that capillary hypertension can initiate remnant glomerular injury even when the majority of the renal mass remains intact.
将接受部分肾切除的Wistar慕尼黑大鼠与完整大鼠进行比较。第1组大鼠双侧节段性梗死，梗死面积占其总肾质量的40%。第2组大鼠接受单侧肾切除术。第3组大鼠接受假手术。术后28周对每组进行微穿刺和形态学研究。在第1组中，尽管肾单位数量仅减少40%，肾小球滤过率（GFR）仅降低10%，但肾小球毛细血管压力升高了7 mmHg，全身血压升高了31 mmHg。该组中进行性蛋白尿和节段性肾小球硬化与肾小球毛细血管压力升高有关。在第2组中，单肾单位肾小球滤过率（SNGFR）高于第1组，但全身和肾小球毛细血管压力保持正常。尽管第2组大鼠残余肾单位超滤更明显，但与第1组大鼠相比，其蛋白尿和肾小球硬化明显较少。这些研究支持以下观点，即肾小球高压是导致残余肾小球损伤的主要血流动力学紊乱，并表明即使大部分肾实质保持完整，毛细血管高压也可引发残余肾小球损伤。
