Lieberthal W, Vasilevsky M L, Valeri C R, Levinsky N G
Am J Physiol. 1987 Feb;252(2 Pt 2):F331-7. doi: 10.1152/ajprenal.1987.252.2.F331.
Interactions between antidiuretic hormone (ADH) and renal prostaglandins in the regulation of sodium reabsorption and urinary concentrating ability were studied in isolated erythrocyte-perfused rat kidneys (IEPK). In this model, hemodynamic characteristics are comparable to those found in vivo, and tubular morphology is preserved throughout the period of perfusion. [Deamino]-D-arginine vasopressin (dDAVP) markedly reduced fractional sodium excretion (FE Na) in the IEPK from 3.5 +/- 0.6 to 0.45 +/- 0.14%. After indomethacin, FE Na fell still further to 0.08 +/- 0.02%. In the absence of dDAVP indomethacin had no effect on sodium excretion; FE Na was 2.4 +/- 0.6% in control and 2.0 +/- 0.4% in indomethacin-treated groups. dDAVP increased urine osmolality in the IEPK to 741 +/- 26 mosmol/kg. When prostaglandin synthesis was blocked with indomethacin, urinary osmolality increased further to 1,180 +/- 94 mosmol/kg. In isolated kidneys perfused without erythrocytes (IPK), dDAVP decreased FENa from 14.5 +/- 1.8% to 9.6 +/- 1.2%; addition of indomethacin had no further effect. dDAVP increased urine osmolality only modestly to 350 +/- 12 mosmol/kg in the IPK and indomethacin did not increase concentrating ability further (342 +/- 7 mosmol/kg). Thus the IEPK (unlike the IPK) can excrete a markedly hypertonic urine in response to ADH. ADH also enhances tubular reabsorption of sodium in the IEPK. Prostaglandins inhibit both these actions of ADH but do not directly affect sodium excretion in the absence of the hormone.
在离体红细胞灌注大鼠肾脏(IEPK)中研究了抗利尿激素(ADH)与肾前列腺素在调节钠重吸收和尿液浓缩能力方面的相互作用。在该模型中,血液动力学特征与体内情况相当,并且在整个灌注期间肾小管形态得以保留。[去氨基]-D-精氨酸加压素(dDAVP)使IEPK中的钠排泄分数(FE Na)从3.5±0.6%显著降低至0.45±0.14%。给予吲哚美辛后,FE Na进一步降至0.08±0.02%。在没有dDAVP的情况下,吲哚美辛对钠排泄没有影响;对照组的FE Na为2.4±0.6%,吲哚美辛处理组为2.0±0.4%。dDAVP使IEPK中的尿渗透压升高至741±26 mosmol/kg。当用吲哚美辛阻断前列腺素合成时,尿渗透压进一步升高至1180±94 mosmol/kg。在无红细胞灌注的离体肾脏(IPK)中,dDAVP使FENa从14.5±1.8%降至9.6±1.2%;添加吲哚美辛没有进一步影响。在IPK中,dDAVP仅使尿渗透压适度升高至350±12 mosmol/kg,吲哚美辛没有进一步提高浓缩能力(342±7 mosmol/kg)。因此,与IPK不同,IEPK能够响应ADH排出明显高渗的尿液。ADH还增强了IEPK中肾小管对钠的重吸收。前列腺素抑制ADH的这两种作用,但在没有该激素的情况下不直接影响钠排泄。