Manning R D
Am J Physiol. 1987 Mar;252(3 Pt 2):F403-11. doi: 10.1152/ajprenal.1987.252.3.F403.
The chronic effects of hyperproteinemia on renal hemodynamics, fluid volume, and arterial pressure were determined in six conscious dogs over a 32-day period. Plasma protein concentration was increased by intravenous infusion of approximately 300 ml/day of previously collected autologous plasma, and the responses to changes in sodium intake were studied. By the end of a 9-day period of hyperproteinemia and normal sodium intake, plasma protein concentration had increased 2.2 g/dl, plasma colloid osmotic pressure had increased 7-8 mmHg, mean arterial pressure had increased 12 mmHg, glomerular filtration rate (GFR) had increased 15%, estimated renal plasma flow (ERPF) had increased 51% primarily due to renal vasodilatation, and filtration fraction had decreased 23%. Also, sodium balance was negative, water balance was positive, sodium iothalamate space had increased, plasma sodium concentration had decreased, and the relationship between mean arterial pressure and urinary sodium excretion was shifted to the right along the arterial pressure axis. In conclusion, long-term increases of plasma protein concentration result in a marked increase in ERPF as well as significant increases in GFR, extracellular fluid volume, and arterial pressure.
在6只清醒犬身上,于32天的时间段内测定了高蛋白血症对肾血流动力学、液体容量和动脉血压的慢性影响。通过每天静脉输注约300毫升先前采集的自体血浆来提高血浆蛋白浓度,并研究对钠摄入量变化的反应。在高蛋白血症和正常钠摄入的9天周期结束时,血浆蛋白浓度增加了2.2克/分升,血浆胶体渗透压增加了7 - 8毫米汞柱,平均动脉压增加了12毫米汞柱,肾小球滤过率(GFR)增加了15%,估计肾血浆流量(ERPF)主要由于肾血管舒张而增加了51%,滤过分数降低了23%。此外,钠平衡为负,水平衡为正,碘肽酸钠空间增加,血浆钠浓度降低,平均动脉压与尿钠排泄之间的关系沿动脉压轴向右移动。总之,血浆蛋白浓度的长期升高导致ERPF显著增加以及GFR、细胞外液容量和动脉血压显著升高。