Wilson D R, Honrath U
Can J Physiol Pharmacol. 1979 Feb;57(2):193-204. doi: 10.1139/y79-029.
The role of the kidney as a source or as the excretory route for natriuretic and kaliuretic factors present in acute uremia was studied using the technique of isovolemic cross-circulation in 49 pairs (eight groups) of anaesthetized rats. Marked and similar natriuresis, kaliuresis, and diuresis occurred in recipients undergoing cross-circulation with donors subjected to either bilateral nephrectomy or total intravenous urine reinfusion for 18 h previously, and were not seen with sham-operated donors. Similar and significant, but less marked, changes occurred in two groups with bilateral nephrectomy or urine reinfusion of only 3 h duration. Urea-loaded normal donors caused a natriuresis and kaliuresis which was similar to the two 18-h uremic donor groups. When donor animals were sodium depleted prior to bilateral nephrectomy the natriuretic response in the recipients was significantly reduced. The results indicate that the kidney is not necessary for the rapid appearance of natriuretic and kaliuretic activity in the blood of acutely uremic animals, and that such activity results from the retention of factors of extrarenal origin. Natriuresis and kaliuresis result from inhibition of tubular reabsorption and are not dependent on changes in glomerular filtration or renal hemodynamics. Pitressin or aldosterone levels. Urea appears to be a major component of the circulating natriuretic and kaliuretic activity in acute uremia but evidence of other factors was also obtained.
采用等容交叉循环技术，对49对（8组）麻醉大鼠进行研究，以探讨肾脏在急性尿毒症中作为利钠和利钾因子的来源或排泄途径所起的作用。与预先接受双侧肾切除术或全静脉尿液回输18小时的供体进行交叉循环的受体，出现了明显且相似的利钠、利钾和利尿现象，而假手术供体则未出现此类现象。在仅进行3小时双侧肾切除术或尿液回输的两组中，也出现了相似且显著但不太明显的变化。尿素负荷的正常供体引起的利钠和利钾作用与两个18小时尿毒症供体组相似。当供体动物在双侧肾切除术前钠缺乏时，受体的利钠反应显著降低。结果表明，对于急性尿毒症动物血液中利钠和利钾活性的快速出现，肾脏并非必需，且此类活性是由肾外来源因子的潴留所致。利钠和利钾是由肾小管重吸收受抑制引起的，不依赖于肾小球滤过或肾血流动力学、抗利尿激素或醛固酮水平的变化。尿素似乎是急性尿毒症中循环利钠和利钾活性的主要成分，但也获得了其他因子存在的证据。
