Städler P, Pusterla C, Beretta-Piccoli C
Ospedale Italiano di Lugano, Viganello, Switzerland.
J Hypertens. 1987 Dec;5(6):727-32. doi: 10.1097/00004872-198712000-00016.
Renal clearance of lithium and sodium, glomerular filtration rate, renal plasma flow and certain other parameters of proximal tubular function were determined in 10 normotensive men without, and 13 normotensive men with a family history of essential hypertension after a low- and high-sodium diet. Under low-sodium conditions, the two groups did not differ in mean body weight, exchangeable sodium, plasma renin activity, clearances of inulin, para-aminohippurate (PAH), lithium, sodium, potassium, uric acid or inorganic phosphate, although blood pressure tended to be slightly, but not significantly, higher in those with a family history of hypertension. After changing to the high sodium diet, body weight, exchangeable sodium, and sodium clearance increased and renin decreased significantly (P less than 0.05) and to a similar extent in the two groups; systolic blood pressure increased only in subjects with a family history of hypertension. In both groups renal clearances of inulin, PAH, lithium, potassium, uric acid and inorganic phosphate remained unchanged. These findings do not support the concept that familial predisposition to hypertension is associated with an enhanced proximal reabsorption of sodium. Moreover, the pressor response to a high sodium intake in predisposed subjects is not mediated by an abnormal adaptation of renal sodium metabolism.
对10名无原发性高血压家族史的血压正常男性和13名有原发性高血压家族史的血压正常男性，在低钠饮食和高钠饮食后，测定了锂和钠的肾清除率、肾小球滤过率、肾血浆流量以及近端肾小管功能的某些其他参数。在低钠条件下，两组的平均体重、可交换钠、血浆肾素活性、菊粉清除率、对氨基马尿酸（PAH）清除率、锂清除率、钠清除率、钾清除率、尿酸清除率或无机磷酸盐清除率均无差异，尽管有高血压家族史者的血压往往略高，但差异不显著。改为高钠饮食后，两组的体重、可交换钠和钠清除率均显著增加（P<0.05），肾素均显著下降，且下降程度相似；收缩压仅在有高血压家族史的受试者中升高。两组的菊粉清除率、PAH清除率、锂清除率、钾清除率、尿酸清除率和无机磷酸盐清除率均保持不变。这些发现不支持高血压家族易感性与近端肾小管钠重吸收增强有关的观点。此外，易患高血压者对高钠摄入的升压反应并非由肾钠代谢的异常适应介导。
