Koch K M, Aynedjian H S, Bank N
J Clin Invest. 1968 Jul;47(7):1696-709. doi: 10.1172/JCI105860.
The effect of acute hypertension on sodium reabsorption by the proximal tubule was studied in rats by means of micropuncture methods. Hypertension was induced by bilateral carotid artery ligation and cervical vagotomy. Within a few minutes after blood pressure rose (30-60 mm Hg above control levels), a moderate natriuresis and diuresis began. Proximal sodium reabsorption, measured by two independent methods, was found to be markedly suppressed, both in absolute amount per unit length and per unit of tubular volume (C/pir(2)). The ratio between tubular volume and glomerular filtration rate (GFR) (pir(2)d/V(0)) was found to be increased. These observations indicate that the inhibition of proximal sodium reabsorption induced by hypertension cannot be explained by the tubular geometry hypothesis of sodium regulation. Several possible hormonal mechanisms were investigated. Intravenous d-aldosterone did not prevent the suppression of sodium transport due to acute hypertension, nor did chronic oral saline loading to reduce the renal content of renin. Constriction of the suprarenal aorta, with maintenance of a normal renal perfusion pressure, did prevent the inhibition of proximal transport during carotid artery occlusion, thus excluding an extrarenally produced natriuretic hormone as the mechanism. The observations are compatible with the view that sodium transport was inhibited either by an intrarenal natriuretic hormone or by an increase in the interstitial volume of the kidney produced by a transient hydrostatic pressure gradient across the peritubular capillaries. The latter seems more likely to us because of the rapidity of onset of the natriuresis, and because removing the renal capsule and releasing the surface interstitial fluid prevented the effect of hypertension on proximal sodium transport.
采用微穿刺法研究了急性高血压对大鼠近端肾小管钠重吸收的影响。通过双侧颈动脉结扎和颈迷走神经切断术诱导高血压。血压升高(比对照水平高30 - 60 mmHg)后的几分钟内,出现了中度利钠和利尿。通过两种独立方法测量发现,近端钠重吸收在单位长度的绝对量和单位肾小管容积(C/πr²)方面均受到明显抑制。发现肾小管容积与肾小球滤过率(GFR)的比值(πr²d/V₀)增加。这些观察结果表明,高血压引起的近端钠重吸收抑制不能用钠调节的肾小管几何假说解释。研究了几种可能的激素机制。静脉注射d - 醛固酮不能阻止急性高血压引起的钠转运抑制,慢性口服生理盐水负荷以降低肾素的肾含量也不能阻止。在维持正常肾灌注压的情况下,缩窄肾上腺主动脉确实能防止颈动脉闭塞期间近端转运的抑制,从而排除了肾外产生的利钠激素作为其机制。这些观察结果与以下观点一致,即钠转运受到抑制要么是由于肾内利钠激素,要么是由于跨肾小管周围毛细血管的瞬时静水压力梯度导致的肾间质容积增加。后一种情况对我们来说似乎更有可能,因为利钠作用起效迅速,而且去除肾包膜并释放表面间质液可防止高血压对近端钠转运的影响。