Auld R B, Alexander E A, Levinsky N G
J Clin Invest. 1971 Oct;50(10):2150-8. doi: 10.1172/JCI106709.
The effect of saline infusion on proximal sodium reabsorption was compared in normal dogs and in dogs with acute or chronic partial thoracic vena cava obstruction. After acute vena cava obstruction, proximal fractional sodium reabsorption rose by 74%. During continued caval obstruction, saline loading strikingly reduced proximal reabsorption but sodium excretion remained minimal. In chronic caval dogs, saline loading reduced proximal fractional sodium reabsorption by 31% but sodium excretion in the micropunctured kidney was only 41 muEq/min. After saline infusion in normal dogs, proximal fractional sodium reabsorption fell 39% while unilateral sodium excretion rose to 584 muEq/min. Nephron filtration rate was also measured before and after saline loading in normal and chronic caval dogs in both repunctured and fresh tubules. There was a marked increase in nephron filtration rate in repunctured tubules and no change in freshly punctured tubules in both groups. The effect of saline loading on nephron filtration rate in normal and chronic caval dogs was similar, therefore, whether repunctured or fresh nephrons were considered.We conclude that saline infusion depresses proximal sodium reabsorption in acute and chronic TVC dogs. Since saline loading markedly increases distal delivery without a concomitant natriuresis, enhanced distal reabsorption must play a major role in the sodium retention exhibited by chronic caval dogs. Redistribution of filtrate does not appear to be a factor in this sodium retention.
在正常犬以及患有急性或慢性部分胸段腔静脉梗阻的犬中,比较了输注生理盐水对近端钠重吸收的影响。急性腔静脉梗阻后,近端钠分数重吸收增加了74%。在持续的腔静脉梗阻期间,生理盐水负荷显著降低了近端重吸收,但钠排泄仍维持在最低水平。在慢性腔静脉梗阻的犬中,生理盐水负荷使近端钠分数重吸收降低了31%,但微穿刺肾的钠排泄仅为41微当量/分钟。在正常犬输注生理盐水后,近端钠分数重吸收下降了39%,而单侧钠排泄升至584微当量/分钟。还在正常犬和慢性腔静脉梗阻犬的再穿刺小管和新鲜小管中,测量了生理盐水负荷前后的肾单位滤过率。两组中,再穿刺小管的肾单位滤过率均显著增加,而新鲜穿刺小管则无变化。因此,无论考虑的是再穿刺肾单位还是新鲜肾单位,生理盐水负荷对正常犬和慢性腔静脉梗阻犬肾单位滤过率的影响是相似的。我们得出结论,输注生理盐水会降低急性和慢性腔静脉梗阻犬的近端钠重吸收。由于生理盐水负荷显著增加了远端输送量,但并未伴随利钠作用,因此增强的远端重吸收必定在慢性腔静脉梗阻犬所表现出的钠潴留中起主要作用。滤液的重新分布似乎不是这种钠潴留的一个因素。