Tyler R D, Qualls C W, Heald R D, Cowell R L, Clinkenbeard K D
Department of Veterinary Pathology, College of Veterinary Medicine, Oklahoma State University, Stillwater 74078.
J Am Vet Med Assoc. 1987 Nov 1;191(9):1095-100.
Eleven hyponatremic dogs were unable to concentrate their urine during periods of severe dehydration and azotemia. When normonatremia was reestablished in eight of the dogs, their renal concentrating ability returned. Six dogs, including the 3 dogs in which normonatremia was not reestablished, died or were euthanatized; renal lesions were not found during postmortem examination. Two dogs had hypoadrenocorticism, which has been documented as a cause of hyponatremia and impaired renal concentrating ability. Two dogs had gastrointestinal disease, which has been documented as a cause of hyponatremia, but not of impairment of renal concentrating ability. All dogs without hypoadrenocorticism had clinical and clinicopathologic indications of blood loss, which has not been documented as a cause of hyponatremia or impairment of renal concentrating ability. Hyponatremia (less than 120 mEq/L) was induced by chronic blood removal in a dog maintained on a low-sodium diet. During the period of hyponatremia, the dog became azotemic, hypotensive, and severely dehydrated; renal concentrating ability was impaired. We conclude that hyponatremia may be caused by hemorrhage, but irrespective of the cause, hyponatremia impairs renal concentrating ability.
11只低钠血症犬在严重脱水和氮质血症期间无法浓缩尿液。当其中8只犬恢复正常血钠水平时,它们的肾脏浓缩能力恢复。6只犬,包括3只未恢复正常血钠水平的犬,死亡或被安乐死;尸检未发现肾脏病变。2只犬患有肾上腺皮质功能减退症,这已被证明是低钠血症和肾脏浓缩能力受损的原因。2只犬患有胃肠道疾病,这已被证明是低钠血症的原因,但不是肾脏浓缩能力受损的原因。所有没有肾上腺皮质功能减退症的犬都有失血的临床和临床病理表现,失血尚未被证明是低钠血症或肾脏浓缩能力受损的原因。在一只维持低钠饮食的犬中,通过慢性放血诱导出低钠血症(低于120 mEq/L)。在低钠血症期间,这只犬出现氮质血症、低血压和严重脱水;肾脏浓缩能力受损。我们得出结论,低钠血症可能由出血引起,但无论原因如何,低钠血症都会损害肾脏浓缩能力。