Gill J R, Casper A G
J Clin Invest. 1971 Jan;50(1):112-8. doi: 10.1172/JCI106464.
Water diuresis was produced in anesthetized hypophysectomized, cortisone-treated dogs by infusion of 2.5% dextrose. Alpha adrenergic blockade of the left kidney produced by infusion of phenoxybenzamine in the left renal artery was associated with a significantly (P < 0.05) greater rate of urine flow (V) and free water excretion (C(H2O)) in the left kidney than in the right despite similar glomerular filtration rates (GFR) (17 +/- 1.3 ml/min, left; 18 +/-0.9 ml/min, right). Sodium excretion (U(Na)V) was similar in the two kidneys (3 and 5 muEq/min). When beta adrenergic stimulation of the left kidney was superimposed on alpha blockade by the addition of isoproterenol to the left renal artery infusate, GFR remained unchanged and similar in the two kidneys, as V and C(H2O) increased significantly (P < 0.01) in the left kidney but not in the right. When isoproterenol was discontinued, V and C(H2O) returned towards control in the left kidney and remained unchanged in the right. The ratios of the left kidney to the right during control, isoproterenol, and postcontrol were 1.22, 1.65, and 1.35, respectively, for V and 1.36, 1.90, and 1.44, respectively, for C(H2O). Sodium excretion remained unchanged and similar in the two kidneys throughout the study. The results indicate that blockade of alpha adrenergic activity inhibits the increased proximal tubular sodium reabsorption which anesthesia induces in the dog. Beta adrenergic stimulation appears to decrease proximal tubular sodium reabsorption but does not prevent virtually complete reabsorption of the increased quantity of delivered sodium by the ascending limb of the loop of Henle and the distal tubule. These changes in sodium reabsorption presumably are not associated with changes in colloid osmotic pressure or hydrostatic pressure in the peritubular capillary inasmuch as cortical and non-cortical plasma flow, filtration fraction, and mean arterial pressure in the left kidney were unchanged. Thus, isoproterenol probably produced its effects through a direct action on the renal tubule, possibly through the mediation of the adenyl cyclase system.
通过输注2.5%的葡萄糖,在麻醉的垂体切除并用可的松处理的犬中产生水利尿。通过在左肾动脉中输注酚苄明对左肾进行α肾上腺素能阻断,尽管两侧肾小球滤过率(GFR)相似(左侧为17±1.3 ml/分钟;右侧为18±0.9 ml/分钟),但左肾的尿流率(V)和自由水清除率(C(H₂O))显著(P<0.05)高于右肾。两肾的钠排泄量(U(Na)V)相似(分别为3和5 μEq/分钟)。当通过在左肾动脉灌注液中加入异丙肾上腺素,使左肾的β肾上腺素能刺激叠加在α阻断上时,两肾的GFR保持不变且相似,而左肾的V和C(H₂O)显著增加(P<0.01),右肾则无变化。当停用异丙肾上腺素时,左肾的V和C(H₂O)恢复至对照水平,右肾则保持不变。对照期、异丙肾上腺素作用期和作用后期左肾与右肾的V比值分别为1.22、1.65和1.35,C(H₂O)比值分别为1.36、1.90和1.44。在整个研究过程中,两肾的钠排泄量保持不变且相似。结果表明,α肾上腺素能活性的阻断抑制了麻醉诱导犬近端肾小管钠重吸收的增加。β肾上腺素能刺激似乎降低了近端肾小管钠重吸收,但并不能阻止亨氏袢升支和远曲小管对增加的输送钠量几乎完全的重吸收。钠重吸收的这些变化大概与肾小管周围毛细血管中的胶体渗透压或静水压的变化无关,因为左肾的皮质和非皮质血浆流量、滤过分数和平均动脉压均未改变。因此,异丙肾上腺素可能是通过对肾小管的直接作用产生其效应的,可能是通过腺苷酸环化酶系统介导的。