Mandin H
J Clin Invest. 1973 Sep;52(9):2225-33. doi: 10.1172/JCI107408.
Animals subjected to certain cardiovascular manipulations, such as arteriovenous fistulas, diminish their urinary sodium excretion. It has been shown that closure of such fistulas results in a prompt increase in the rate of sodium excretion. However, the nature of the renal mechanisms increasing the excretion of sodium when the initial cardiovascular abnormality is corrected has remained unclear. Since the elucidation of such mechanisms might provide information pertinent to other sodium-retaining states, the effect of closure of chronic Teflon-Silastic arteriovenous shunts was studied in desoxycorticosterone acetate (DOCA)-treated dogs by utilizing micropuncture techniques.Nephron filtration rates were measured first during a control period with open arteriovenous shunts and then again after closure of the shunts in 12 dogs. Nephron filtration rate rose 32% while total glomerular filtration rate (GFR) decreased 8%. After closure of the arteriovenous shunt, fractional reabsorption increased 6%, while total kidney filtration fraction increased from 0.31 to 0.35. Renal plasma flow decreased from a mean of 111 ml/min to 90 ml/min. Closure of the arteriovenous shunts increased sodium excretion from a mean of 21 mueq/min to 45 mueq/min. Concomitantly, a redistribution of filtrate to superficial nephrons occurred. Since pharmacological doses of DOCA were being administered while total GFR was not increased and fractional reabsorption of sodium in the proximal tubule was not inhibited, it was concluded that filtrate distribution to superficial nephrons may have contributed to the observed natriuresis, although alternate explanations were also deemed possible.
接受某些心血管操作(如动静脉瘘)的动物,其尿钠排泄会减少。已表明,闭合此类瘘管会导致钠排泄率迅速增加。然而,当初始心血管异常得到纠正时,增加钠排泄的肾脏机制的本质仍不清楚。由于阐明此类机制可能会提供与其他钠潴留状态相关的信息,因此利用微穿刺技术,在接受醋酸脱氧皮质酮(DOCA)治疗的犬中研究了闭合慢性聚四氟乙烯 - 硅橡胶动静脉分流术的效果。首先在动静脉分流开放的对照期测量12只犬的肾单位滤过率,然后在分流闭合后再次测量。肾单位滤过率上升了32%,而总肾小球滤过率(GFR)下降了8%。动静脉分流闭合后,分数重吸收增加了6%,而总肾滤过分数从0.31增加到0.35。肾血浆流量从平均111毫升/分钟降至90毫升/分钟。动静脉分流闭合使钠排泄从平均21微当量/分钟增加到45微当量/分钟。同时,滤液重新分布到浅表肾单位。由于在总GFR未增加且近端小管中钠的分数重吸收未受抑制的情况下给予了药理剂量的DOCA,因此得出结论,滤液向浅表肾单位的分布可能促成了观察到的利钠作用,尽管也认为可能有其他解释。