ter Wee P M, Rosman J B, van der Geest S, Sluiter W J, Donker A J
Kidney Int. 1986 Apr;29(4):870-4. doi: 10.1038/ki.1986.79.
Healthy volunteers (N = 9) and patients with varying degrees of renal insufficiency (N = 36) were given a low dose of dopamine and/or amino acids intravenously during a simultaneous measurement of the glomerular filtration rate and the effective renal plasma flow. Dopamine infusion led to a rise in the glomerular filtration rate and a fall in the filtration fraction. Infusion of amino acids was accompanied by an increase in the glomerular filtration rate while the filtration fraction remained unchanged or increased slightly. The highest values for the glomerular filtration were obtained during the combined infusion of amino acids and dopamine. A reserve in filtration capacity was not or hardly present in patients with moderate (GFR 30 to 90 mliter/min/1.73 M2) to severe (GFR less than 30 mliter/min/1.73 M2) renal insufficiency. We conclude that dopamine decreases total renal vascular resistance while amino acids mainly reduce the tone of afferent arterioles. As amino acids and dopamine seem to be additive in their effects on the glomerular filtration rate, we recommend the combined infusion of these two stimuli to measure renal reserve filtration capacity.
在同时测量肾小球滤过率和有效肾血浆流量的过程中，对9名健康志愿者和36名不同程度肾功能不全的患者静脉注射低剂量多巴胺和/或氨基酸。输注多巴胺导致肾小球滤过率升高，滤过分数降低。输注氨基酸时，肾小球滤过率增加，而滤过分数保持不变或略有增加。在氨基酸和多巴胺联合输注时，肾小球滤过率达到最高值。中度（肾小球滤过率30至90毫升/分钟/1.73平方米）至重度（肾小球滤过率低于30毫升/分钟/1.73平方米）肾功能不全的患者不存在或几乎不存在滤过能力储备。我们得出结论，多巴胺降低总肾血管阻力，而氨基酸主要降低入球小动脉张力。由于氨基酸和多巴胺对肾小球滤过率的影响似乎具有相加作用，我们建议联合输注这两种刺激物以测量肾储备滤过能力。
