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氯化钠诱导的肾毒性急性肾衰竭保护作用:与肾素无关

Sodium-chloride-induced protection in nephrotoxic acute renal failure: independence from renin.

作者信息

Bidani A, Churchill P, Fleischmann L

出版信息

Kidney Int. 1979 Oct;16(4):481-90. doi: 10.1038/ki.1979.153.

Abstract

It has been shown that the severity of experimentally induced acute renal failure (ARF) is inversely related to dietary sodium chloride intake, and the effects have been attributed to the concurrent changes in renal renin. In the current study, renal renin of rats was increased by chronic sodium deprivation and decreased by chronic sodium loading and DOCA administration. In two nephrotoxic models (mercuric chloride, uranyl nitrate), giving previously sodium-deprived rats 1% sodium chloride to drink for 48 hours prior to ARF induction greatly attenuated the severity without any reduction in their high renal renin. Conversely, giving previously sodium-loaded rats tap water to drink for 4 to 5 days prior to AFR induction greatly enhanced the severity without any increase in their subnormal renal renin. Therefore, the changes in severity of ARF resulting from changes in dietary sodium are not mediated by changes in renal renin. Significant inverse correlations were found between mean peak BUN values during the follow-up period (5 to 7 days) and the 24-hour urinary sodium excretions prior to ARF induction in both models, suggesting that sodium intake and/or excretion at the time of induction is a good predictor of the severity. The effects of sodium chloride in both models were predominantly expressed during the maintenance phase, and consisted of attenuation of the severity (both models) and hastening of the recovery (mercuric chloride model). Possible mechanisms by which dietary sodium produced its effects, independently of its effects on the renin-angiotensin system, are discussed.

摘要

研究表明,实验性诱导的急性肾衰竭(ARF)的严重程度与饮食中氯化钠的摄入量呈负相关,其作用归因于肾脏肾素的同时变化。在当前研究中,慢性缺钠可使大鼠肾脏肾素增加,而慢性钠负荷和给予去氧皮质酮(DOCA)则使其降低。在两种肾毒性模型(氯化汞、硝酸铀酰)中,在诱导ARF前48小时让先前缺钠的大鼠饮用1%氯化钠溶液,可大大减轻ARF的严重程度,而它们的高肾素水平并未降低。相反,在诱导AFR前4至5天让先前钠负荷的大鼠饮用自来水,可大大加重ARF的严重程度,而它们低于正常的肾素水平并未升高。因此,饮食中钠的变化导致的ARF严重程度的改变并非由肾脏肾素的变化介导。在两种模型中,随访期(5至7天)内的平均BUN峰值与ARF诱导前24小时尿钠排泄量之间均存在显著的负相关,这表明诱导时的钠摄入和/或排泄是严重程度的良好预测指标。两种模型中氯化钠的作用主要在维持期表现出来,包括减轻严重程度(两种模型)和加速恢复(氯化汞模型)。本文讨论了饮食中钠产生其作用的可能机制,这些机制独立于其对肾素-血管紧张素系统的作用。

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