Cowley A W, Lohmeier T E
Hypertension. 1979 Nov-Dec;1(6):549-58. doi: 10.1161/01.hyp.1.6.549.
Experiments were performed on conscious uninephrectomized dogs to determine the comparative effects of chronic intrarenal and intravenous norephrine (NE) infusion (0.27 microgram/kg/min) on the steady-state values for arterial pressure, plasma renin activity (PRA), and renal function at four levels of sodium intake (5, 40, 120 and 240 mEq/day). Arterial pressure was monitored continuously 24 hr/day with on-line computer techniques. Glomerular filtration rate (GFR), effective renal plasma flow (ERPF), and plasma renin activity (PRA) were determined after sodium and water balance was achieved. During intrarenal NE infusion, ERPF and GFR decreased progressively from 15% to 30% and from 24% to 46% respectively, while renal vascular resistance increased progressively from 40% to 140% as sodium intake was increased from 10 to 240 mEq/day. Both ERPF and renal resistance, but not GFR, returned to control levels during intravenous NE infusion at each level of sodium intake and after terminating NE infusion. During intrarenal NE infusion the steady-state value for mean arterial pressure increased from a control of 105 to 118 mm Hg when the sodium intake was 10 mEq/day. Pressure then increased progressively from 118 to 135 mm Hg as the sodium intake was elevated from 10 to 240 mEq/day. Increases in arterial pressure associated with intravenous NE infusion were significantly smaller at each sodium level than those achieved with intrarenal NE infusion. At each level of sodium intake, PRA was elevated during intrarenal NE infusion and returned to control after NE infusion. Intravenous NE infusion did not increase PRA above control levels. The data are compatible with the concept that enhanced renal adrenergic activity could initiate and sustain hypertension chronically by basic alterations in renal function.
在清醒的单侧肾切除犬身上进行实验,以确定慢性肾内和静脉输注去甲肾上腺素(NE,0.27微克/千克/分钟)对四种钠摄入量水平(5、40、120和240毫当量/天)下动脉血压、血浆肾素活性(PRA)和肾功能稳态值的比较影响。采用在线计算机技术每天24小时连续监测动脉血压。在实现钠和水平衡后,测定肾小球滤过率(GFR)、有效肾血浆流量(ERPF)和血浆肾素活性(PRA)。在肾内输注NE期间,随着钠摄入量从10增加到240毫当量/天,ERPF和GFR分别从15%逐渐下降到30%和从24%逐渐下降到46%,而肾血管阻力从40%逐渐增加到140%。在每个钠摄入量水平的静脉输注NE期间以及终止NE输注后,ERPF和肾阻力(但不是GFR)恢复到对照水平。在肾内输注NE期间,当钠摄入量为10毫当量/天时,平均动脉压的稳态值从对照值105毫米汞柱增加到118毫米汞柱。随着钠摄入量从10增加到240毫当量/天,血压随后从118毫米汞柱逐渐增加到135毫米汞柱。在每个钠水平下,与静脉输注NE相关的动脉压升高明显小于肾内输注NE时的升高幅度。在每个钠摄入量水平,肾内输注NE期间PRA升高,输注后恢复到对照水平。静脉输注NE未使PRA升高超过对照水平。这些数据与以下概念相符,即增强的肾肾上腺素能活性可通过肾功能的基本改变长期引发和维持高血压。