Premen A J
Med Hypotheses. 1986 Mar;19(3):295-309. doi: 10.1016/0306-9877(86)90077-0.
Unlike the intestinal hyperemia which occurs following ingestion of a mixed meal, postprandial renal hemodynamic responses to food appear to be specific to protein-rich meals. Several observations have led to the proposal that following ingestion of protein (meat), a blood-borne factor(s) is released into the systemic circulation which elicits the increases in renal hemodynamics. Glucagon was initially considered as a prime hormonal candidate since the polypeptide is preferentially secreted by the endocrine pancreas in response to protein-rich meals and because glucagon elevates renal hemodynamics by selectively dilating renal afferent arterioles. However, recent data indicate that at postprandial blood levels, glucagon fails to directly mediate protein-induced renal hyperemia and hyperfiltration thus questioning the physiologic importance of glucagon on the renal vasculature. Data have accumulated indicating the importance of the liver and hepatic metabolism during protein-mediated elevations in renal hemodynamics. A hypothesis is advanced suggesting the existence and physiologic importance of a "hepato-renal axis" in mediating the postprandial increases in renal hemodynamics following ingestion of protein-rich meals. The blood-borne factor(s) mediating this response remains to be further clarified and defined.
与进食混合餐食后出现的肠道充血不同，餐后肾脏对食物的血流动力学反应似乎对富含蛋白质的餐食具有特异性。多项观察结果提示，摄入蛋白质（肉类）后，一种血源性因子会释放到体循环中，从而引发肾脏血流动力学的增加。胰高血糖素最初被认为是主要的激素候选物，因为这种多肽是内分泌胰腺在摄入富含蛋白质的餐食后优先分泌的，而且胰高血糖素通过选择性扩张肾入球小动脉来提高肾脏血流动力学。然而，最近的数据表明，在餐后血药浓度下，胰高血糖素无法直接介导蛋白质诱导的肾脏充血和超滤，因此对胰高血糖素在肾脏血管系统中的生理重要性提出了质疑。越来越多的数据表明，肝脏和肝脏代谢在蛋白质介导的肾脏血流动力学升高过程中具有重要作用。有人提出了一个假说，认为存在一个“肝肾轴”，其在介导摄入富含蛋白质餐食后餐后肾脏血流动力学增加方面具有生理重要性。介导这种反应的血源性因子仍有待进一步阐明和界定。
