Kaloyanides G J, Azer M
J Clin Invest. 1972 May;51(5):1297-300. doi: 10.1172/JCI106925.
Previous studies reported from this laboratory provided support for the hypothesis that the natriuresis of volume expansion is mediated in part by a humoral mechanism. In the present study we examined whether suppression of this factor participates in the antinatriuresis of acute constriction of the thoracic inferior vena cava. An isolated kidney was perfused by a second dog pretreated with deoxycorticosterone acetate. Expansion of the perfusion dog with equilibrated blood from a reservoir resulted in an increase in sodium excretion from 102+/-30 to 259+/-65 muEq/min, P < 0.001. Fractional sodium excretion increased from 2.3+/-0.6 to 6.2+/-1.2%, P < 0.01. Inulin clearance, plasma protein concentration, and packed cell volume remained constant; renal perfusion pressure and renal blood flow decreased. After the natriuresis was established, the thoracic inferior vena cava was constricted to decrease systemic arterial pressure in the perfusion dog 50 mm Hg. This maneuver suppressed urine output in the dog but did not significantly alter sodium excretion in the isolated kidney. During the period of caval constriction absolute sodium excretion in the isolated kidney measured 198+/-42 muEq/min and fractional sodium excretion measured 5.7+/-1.1%. Neither value is significantly different from that measured during volume expansion alone. The data suggest that the antinatriuresis of acute caval constriction probably does not require suppression of a humoral natriuretic factor and that other more rapidly acting mechanisms, presumably hemodynamic and neural, may be involved.
本实验室之前的研究报告为容量扩张性利钠作用部分由体液机制介导这一假说提供了支持。在本研究中,我们检测了该因子的抑制是否参与了胸段下腔静脉急性缩窄后的抗利尿钠作用。用醋酸脱氧皮质酮预处理的第二只狗对一个离体肾脏进行灌注。用来自储液器的平衡血液使灌注狗扩容,导致钠排泄量从102±30增加至259±65μEq/分钟,P<0.001。钠排泄分数从2.3±0.6增加至6.2±1.2%,P<0.01。菊粉清除率、血浆蛋白浓度和红细胞压积保持恒定;肾灌注压和肾血流量下降。在利钠作用确立后,胸段下腔静脉被缩窄,使灌注狗的体动脉压降低50mmHg。这一操作抑制了狗的尿量,但未显著改变离体肾脏的钠排泄。在腔静脉缩窄期间,离体肾脏的绝对钠排泄量为198±42μEq/分钟,钠排泄分数为5.7±1.1%。这两个值与仅在容量扩张期间测得的值均无显著差异。数据表明,急性腔静脉缩窄后的抗利尿钠作用可能不需要抑制一种体液性利钠因子,可能涉及其他作用更快的机制,大概是血流动力学和神经机制。