Finotti P, Antonello A
Clin Pharmacol Ther. 1982 Jul;32(1):1-6. doi: 10.1038/clpt.1982.118.
Changes in plasma renin activity (PRA) were monitored in six mildly hypertensive men after intravenous doses, in seven separate experiments, of placebo, digoxin, potassium canrenoate, potassium canrenoate with digoxin, furosemide, furosemide with digoxin, and potassium canrenoate with furosemide and digoxin. Potassium canrenoate has been used as a rapid source of canrenone, which has been recently shown to be a competitive antagonist of ouabain at its Na-K-ATPase receptor site. Potassium canrenoate infusion reversed the hyporeninemic effect of digoxin. This result has been taken as evidence that: (1) antialdosteronic drugs can also reverse digoxin effects at extracardiac level and (2) the Na-K-ATPase system is involved in the renin secretory mechanism. A seemingly identical reversal of the hyporeninemic effect of digoxin was induced by furosemide, which, when given alone, stimulated renin secretion. The simultaneous administration of potassium canrenoate, digoxin, and furosemide induced an increase in PRA on the same order as that after furosemide alone. This result indicates that furosemide stimulates renin release by affecting a biochemical system other than that affected by digoxin.
在七项独立实验中，对六名轻度高血压男性静脉注射安慰剂、地高辛、坎利酸钾、坎利酸钾与地高辛联用、呋塞米、呋塞米与地高辛联用以及坎利酸钾与呋塞米和地高辛联用后，监测其血浆肾素活性（PRA）的变化。坎利酸钾一直被用作烯睾丙内酯的快速来源，最近研究表明，烯睾丙内酯在其钠钾ATP酶受体位点是哇巴因的竞争性拮抗剂。输注坎利酸钾可逆转地高辛的低肾素血症效应。这一结果被视为以下证据：（1）抗醛固酮药物也可在心脏外水平逆转地高辛的效应；（2）钠钾ATP酶系统参与肾素分泌机制。呋塞米也可诱导地高辛低肾素血症效应出现看似相同的逆转，单独使用呋塞米时会刺激肾素分泌。同时给予坎利酸钾、地高辛和呋塞米可使PRA升高，其幅度与单独使用呋塞米后相同。这一结果表明，呋塞米通过影响不同于地高辛所影响的生化系统来刺激肾素释放。
