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球管反馈。肾小球静水压力与髓袢灌注率之间的非线性关系。

Tubuloglomerular feedback. Nonlinear relation between glomerular hydrostatic pressure and loop of henle perfusion rate.

作者信息

Schnermann J, Persson A E, Agerup B

出版信息

J Clin Invest. 1973 Apr;52(4):862-9. doi: 10.1172/JCI107250.

Abstract

The present experiments were performed to quantify the effect of changes in distal tubular sodium delivery on glomerular flow dynamics both below and above the normal physiologic range. Glomerular capillary pressure as derived from the tubular stop flow pressure was assessed while the loop of Henle of the same nephron was perfused with varying flow rates. During Ringer perfusion no change of glomerular capillary pressure was observed when flow was increased from 0 to 13 nl/min. Further increasing flow to 27 nl/min was associated with a reduction of glomerular hydrostatic pressure by an average of 7.0+/-4.4 cm H(2)O (+/-SD). During perfusion at a rate of 43 nl/min glomerular pressure was decreased by a mean of 10.5+/-4.0 cm H(2)O. Changing the flow rate in small steps revealed that a significant reduction of capillary pressure was found when increasing the flow rate from 13 to 21 nl/min and that the maximum response was reached at 32 nl/min. No effect of perfusion rate changes on glomerular capillary pressure was observed when 300 mM mannitol was used as perfusion fluid. These results imply that a nonlinear relationship exists between end-proximal flow rate and glomerular capillary pressure. It is suggested that during deviations of distal sodium delivery into a positive direction filtration rate is intrarenally regulated probably by prevalence of afferent arteriolar constriction. During reductions of distal sodium load intrarenal regulation is either abolished or it involves proportionate resistance changes of both afferent and efferent arterioles.

摘要

进行本实验是为了量化远曲小管钠输送变化对正常生理范围上下的肾小球血流动力学的影响。在以不同流速灌注同一肾单位的髓袢时,评估由肾小管停流压力得出的肾小球毛细血管压力。在林格液灌注期间,当流速从0增加到13 nl/min时,未观察到肾小球毛细血管压力的变化。进一步将流速增加到27 nl/min,肾小球静水压平均降低7.0±4.4 cmH₂O(±标准差)。在以43 nl/min的速率灌注期间,肾小球压力平均降低10.5±4.0 cmH₂O。小步改变流速显示,当流速从13增加到21 nl/min时,毛细血管压力显著降低,且在32 nl/min时达到最大反应。当使用300 mM甘露醇作为灌注液时,未观察到灌注速率变化对肾小球毛细血管压力的影响。这些结果表明,近端末段流速与肾小球毛细血管压力之间存在非线性关系。提示当远曲小管钠输送向正向偏差时,滤过率可能通过入球小动脉收缩占优势而在肾内受到调节。当远曲小管钠负荷减少时,肾内调节要么被消除,要么涉及入球和出球小动脉的成比例阻力变化。

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